| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203510 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 4.08% |
| KRISTI J. FISHBACK3 | PO BOX 405 BATAVIA, OH 45103 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 3.39% |
| MJ INSURANCE3 Filed as: GENESIS M COFFEY AND VARIOUS AGENTS | 8150 CORPORATE PARK DRIVE SUITE 222 CINCINNATI, OH 45242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 2.97% |
| THOMAS FISHBACK3 | PO BOX 405 BATAVIA, OH 45103 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.82% |
| WELLS FARGO INSURANCE SERVICES3 | 720 PETE ROSE WAY, SUITE 400 CINCINNATI, OH 45202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 10 SOUTH LASALLE STREET, SUITE 3000 CINCINNATI, OH 45246 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.55% |
| MARK E CASE3 Filed as: MARK E. CASE | 6821 WELLINGTON PLACE CASTLE PINES, CO 80108 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.45% |
| MICHAEL D AISSEN3 Filed as: MICHAEL D. AISSEN | 920 HOLCOMB BRIDGE ROAD, SUITE 200 ROSWELL, GA 30076 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.99% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 606 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 606 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 1,456 | $314K |
| Vision | EYEMED VISION CARE | 1,303 | $52K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 606 | $326K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 606 | $326K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 606 | $326K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 606 | $449K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,456 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.