| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BASIC BENEFITS3 Filed as: BASIC BENEFITS INC | 1921 MAPLE AVE ZANESVILLE, OH 43701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $66K | — | $66K | 4.12% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - CLE | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $27K | $17K | $43K | 2.68% |
| VHA CENTRAL INSURANCE SERVICES3 | 8900 KEYSTONE CROSSING STE 480 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 0.82% |
| SOBA REACQUISITION CORP3 | 2101 FLORENCE AVE CINCINNATI, OH 45206 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $0 | $45K | $45K | 4.85% |
| BASIC BENEFITS3 Filed as: BASIC BENEFITS INC | 1921 MAPLE AVE ZANESVILLE, OH 43701 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.15% |
| THE FORKER COMPANY3 Filed as: THE FORKER CO. | PO BOX 2040 ZANESVILLE, OH 43702 | VISION SERVICE PLAN | $6K | — | $6K | 1.35% |
| THE FORKER COMPANY3 Filed as: THE FORKER AGENCY INC | PO BOX 2040 ZANESVILLE, OH 43702 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 2.51% |
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 | 4,951 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 116 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,067 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,175 | $472K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 3,039 | $922K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,725 | $2.0M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,725 | $2.0M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,039 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,039 | — |
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.