| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO3 Filed as: INTEGRATED EMPLOYEE BENEFITS SOLUTI | 5880 VENTURE DR DUBLIN, OH 43017 | FIDELITY SECURITY LIFE | $40K | — | $40K | 15.00% |
| STAEBLER GROUP3 | 575 COPELAND MILL RD WESTERVILLE, OH 43081 | SUN LIFE | $18K | — | $18K | 11.76% |
| MEDICAL BENEFITS ADMINISTRATORS5 | 1975 TAMARACK BLVD NEWARK, OH 43055 | SUN LIFE | $9K | — | $9K | 5.88% |
| MEDICAL BENEFITS ADMINISTRATORS5 | 1975 TAMARACK RD NEWARK, OH 43055 | MEDICAL STOP LOSS COVERAGE HCC BENEFITS | $23K | — | $23K | 17.65% |
| STAEBLER GROUP3 Filed as: THE STAEBLER GROUP | 575 COPELAND MILL RD, STE 2D WESTERVILLE, OH 43081 | MEDICAL STOP LOSS COVERAGE HCC BENEFITS | $16K | — | $16K | 11.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | — | $36K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 CONTRACT | Other fees Service code 99 | — | $24K |
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 | 288 | 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) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | MEDICAL STOP LOSS COVERAGE HCC BENEFITS | 123 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.
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.