| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | $114K | $816 | $115K | 5.64% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN MARQUIS AGENCY, INC. | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | $0 | $1K | $1K | 0.05% |
| SAMUEL J. GROOMS3 | 4930 COMMON MARKET PLACE DUBLIN, OH 43016 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 11.12% |
| THE WORKSITE GROUP LLC3 Filed as: THE WORKSITE GROUP, LLC | 1900 POLARIS PARKWAY, SUITE 450 COLUMBUS, OH 43240 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $72 | $2K | 1.48% |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 354 | $2.0M |
| Dental | COMMUNITY INSURANCE COMPANY | 354 | $2.0M |
| Vision | COMMUNITY INSURANCE COMPANY | 354 | $2.0M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $116K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $116K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $116K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 354 | $2.0M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.