| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAI INSURANCE AGENCY INC3 Filed as: CAI INSURANCE AGENCY, INC. | 2035 READING ROAD CINCINNATI, OH 45202 | DENTAL CARE PLUS, INC. | $4K | — | $4K | 5.16% |
| CAI INSURANCE AGENCY INC3 Filed as: CAI INSURANCE AGENCY, INC. | 2035 READING ROAD CINCINNATI, OH 45202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAI INSURANCE AGENCY, INC. EIN 31-0572951 NONE | Consulting (general); Claims processing; Plan Administrator; Contract Administrator Service code 12 | 2035 READING ROAD CINCINNATI, OH 45202 | $40K |
| HEALTHSPAN, INC. EIN 31-1431434 NONE | Other insurance fees and expenses Service code 73 | 225 PICTORIA DRIVE CINCINNATI, OH 45246 | $14K |
| UNITED CLAIM SOLUTIONS EIN 20-0908354 NONE | Claims processing Service code 12 | 10835 N 25TH AVENUE PHOENIX, AZ 85029 | $2K |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL CARE PLUS, INC. | 152 | $73K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $56K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $56K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 151 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.