| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI | 312 ELM STREET CINCINNATI, OH 45202 | ZURICH AMERICAN | $16K | $2K | $19K | 6.78% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | ZURICH AMERICAN | $3K | — | $3K | 1.22% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $248 | $3K | 3.87% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $586 | $3K | 3.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | THE GUARDIAN LIFE INSURANCE COMPANY | $848 | — | $848 | 6.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | THE GUARDIAN LIFE INSURANCE COMPANY | $417 | $357 | $774 | 5.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 INSURANCE COMPANY | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $103K |
| EXPRESS SCRIPTS EIN 31-1714795 INSURANCE COMPANY | Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
| USI EIN 31-0507943 BROKER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
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 | 293 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 769 | $86K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 210 | $13K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 769 | $86K |
| Stop-loss / reinsurancereinsurance | ZURICH AMERICAN | 229 | $274K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 769 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 769 | — |
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.