| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS, LLC | 20 N WACKER DR SUITE 500 CHICAGO, IL 60606 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.00% |
| CLEARPATH BENEFIT ADVISORS LLC3 Filed as: CLEARPATH BENEFIT ADVISORS | 300 E BROAD ST SUITE 530 COLUMBUS, OH 43215 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| CLEARPATH BENEFIT ADVISORS LLC3 Filed as: CLEARPATH BENEFIT ADVISORS | 300 E BROAD ST SUITE 530 COLUMBUS, OH 43215 | DELTA DENTAL | $4K | $0 | $4K | 2.95% |
| CLEARPATH BENEFIT ADVISORS LLC3 Filed as: CLEARPATH BENEFIT ADVISORS | 300 E BROAD ST SUITE 530 COLUMBUS, OH 43215 | AMERICAN UNITED LIFE INSURANCE COMPANY | $6K | $0 | $6K | 7.77% |
| CLEARPATH BENEFIT ADVISORS LLC3 Filed as: CLEARPATH BENEFIT ADVISORS | 300 E BROAD ST SUITE 530 COLUMBUS, OH 43215 | EYEMED | $3K | $0 | $3K | 10.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS ADMINISTRATOR | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $62K |
| CLEARPATH BENEFIT ADVISORS EIN 46-1168380 BROKER | Claims processing; Contract Administrator; Insurance agents and brokers; Other commissions; Product termination fees (surrender charges, etc.); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 300 E BROAD ST SUITE 530 COLUMBUS, OH 43215 | $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 | 213 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 201 | $126K |
| Vision | EYEMED | 200 | $33K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 213 | $78K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 213 | $78K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 204 | $377K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 213 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.