| 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 | $43K | — | $43K | 3.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - CLE | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $15K | $39K | 3.27% |
| THE FORKER COMPANY3 Filed as: THE FORKER AGENCY INC | PO BOX 2040 ZANESVILLE, OH 43702 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 1.45% |
| VHA MID AMERICA INS SVCS3 Filed as: VHA MID-AMERICA INSURANCE SERV | STE 200, 7415 W. 130TH STREET OVERLAND PARK, KS 66213 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 1.00% |
| SOBA REACQUISITION CORP3 | 2101 FLORENCE AVE CINCINNATI, OH 45206 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $0 | $40K | $40K | 4.42% |
| THE FORKER COMPANY3 Filed as: FORKER AGENCY | PO BOX 2040 ZANESVILLE, OH 43702 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $15K | $1K | $16K | 1.73% |
| MEDBEN MARKETING SERVICES3 Filed as: MEDBEN MARKETING SERVICES INC | — | NATIONAL UNION FIRE INSURANCE COMPANY | — | $20K | $20K | 3.09% |
| 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 | $8K | — | $8K | 2.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFIT ADMINISTRATORS EIN 31-1249371 NONE | Plan Administrator Service code 14 | — | $605K |
| RANKIN AND RANKIN, INC. EIN 31-4287570 NONE | Insurance agents and brokers Service code 22 | — | $58K |
| PHCS EIN 04-3138814 NONE | Other fees Service code 99 | — | $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 | 2,378 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 96 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,197 | $475K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 3,051 | $907K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,764 | $1.5M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,764 | $1.5M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,051 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,051 | — |
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.