| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RXBENEFITS, INC.3 Filed as: RXBENEFITS | 3700 COLONNADE PARKWAY BIRMINGHAN, AL 35243 | RXBENEFITS | $0 | $2K | $2K | 0.69% |
| SCHWENDEMAN AGENCY, INC.3 | 109 PUTMAN STREET MARIETTA, OH 45750 | UNITED OF OMAHA | $16K | $8K | $25K | 18.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | EYEMED | $2K | — | $2K | 9.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $133K |
| MCGOHAN BRABENDER EIN 31-1191330 BROKER | Other commissions Service code 55 | — | $37K |
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS ADMINISTRATOR | Float revenue; Claims processing; Contract Administrator; Investment advisory (plan); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $28K |
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 | 263 | 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) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED | 372 | $22K |
| Life insurance | UNITED OF OMAHA | 234 | $131K |
| Long-term disability | UNITED OF OMAHA | 234 | $131K |
| Prescription drug | RXBENEFITS | 192 | $340K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 195 | $300K |
| Other | UNITED OF OMAHA | 234 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.