| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEARPATH BENEFIT ADVISORS LLC3 | 300 SPRUCE ST STE 250 COLUMBUS, OH 43215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $3K | $12K | 16.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY (G1728) EIN 31-1440175 PRESCRIPTION DRUG/ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | — | $190K |
| COMMUNITY INSURANCE COMPANY | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Float revenue Service code 12 | — | $109K |
| CLEARPATH BENEFIT ADVISORS LLC EIN 46-1168380 SALES/BASE COMMISSION | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions; Non-monetary compensation Service code 22 | 777 GOODALE BLVD, STE 200 COLUMBUS, OH 43212 | $36K |
| CLEARPATH BENEFITS ADVISORS LLC | Non-monetary compensation; Other commissions; Insurance agents and brokers Service code 22 | — | $15K |
| INGENIO RX, INC EIN 82-3062245 ADMIN SERVICE PROVIDER | Contract Administrator; Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $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 | 544 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $74K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $74K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $74K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (G1728) | 610 | $283K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 610 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.