| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 285 COZZINS ST COLUMBUS, OH 43215 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | $3K | $16K | 4.10% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST STE 300 ROCKY RIVER, OH 44116 | SYMETRA FINANCIAL | $7K | — | $7K | 10.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT STREET ROCKY RIVER, OH 44116 | MEDICAL BENEFITS MUTUAL DENTAL | $3K | — | $3K | 7.04% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST STE 300 ROCKY RIVER, OH 44116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $91 | $3K | 10.34% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST STE 300 ROCKY RIVER, OH 44116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $41 | $2K | 14.12% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST. STE 300 ROCKY RIVER, OH 44116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $604 | $23 | $627 | 9.58% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 1340 DEPOT STREET SUITE 300 CLEVELAND, OH 44116 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $425 | — | $425 | 6.60% |
| GEORGE R. HAAG3 | 1612 N. 21ST ST. NEWARK, OH 43055 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 1.39% |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 80 | $397K |
| Dental | MEDICAL BENEFITS MUTUAL DENTAL | 141 | $37K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 121 | $6K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $37K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $37K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $26K |
| Other(3 contracts, 3 carriers) | SYMETRA FINANCIAL | 139 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.