| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAI INSURANCE AGENCY INC3 Filed as: CAI INSURANCE | 2035 READING ROAD CINCINNATI, OH 45202 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CUSTOM DESIGN BENEFITS, LLC EIN 81-0798821 NONE | Claims processing Service code 12 | 5589 CHEVIOT RD. CINCINNATI, OH 45202 | $56K |
| CAI INSURANCE AGENCY, INC. EIN 31-0572951 NONE | Consulting (general); Claims processing; Plan Administrator Service code 12 | 2035 READING ROAD CINCINNATI, OH 45202 | $38K |
| RX RESULTS EIN 26-3233073 NONE | Contract Administrator Service code 13 | 320 EXECUTIVE CT STE 201 LITTLE ROCK, AR 72205 | $5K |
| THE PHIA GROUP EIN 46-1439866 NONE | Consulting (general) Service code 16 | 163 BAY STATE DR BRAINTREE, MA 02184 | $5K |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 109 | $63K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 106 | $298K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.