| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EUGENE J. ROSSI3 | 701 FAIRWAY DRIVE NE WARREN, OH 44483 | GUARDIAN LIFE INSURANCE CO. OF AMERICA | $19K | — | $19K | 7.47% |
| EUGENE J. ROSSI3 | 201 EAST COMMERCE STREET STE 337 YOUNGSTOWN, OH 44503 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | — | $15K | 10.37% |
| EUGENE J. ROSSI3 | 201 EAST COMMERCE STREET STE 337 YOUNGSTOWN, OH 44503 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 9.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Claims processing; Other fees; Float revenue; Direct payment from the plan Service code 12 | — | $506K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $110K |
| E.J. ROSSI & COMPANY EIN 27-7541595 BROKER | Other commissions Service code 55 | 201 E. COMMERCE STREET SUITE 337 YOUNGSTOWN, OH 44503 | $42K |
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 | 373 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SYMETRA LIFE INSURANCE COMPANY | 243 | $346K |
| Dental(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 373 | $595K |
| Vision(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 373 | $595K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 373 | $595K |
| Short-term disability(3 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 373 | $741K |
| Long-term disability(3 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 373 | $642K |
| Prescription drug | SYMETRA LIFE INSURANCE COMPANY | 243 | $346K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 243 | $346K |
| Other | GUARDIAN LIFE INSURANCE CO. OF AMERICA | 373 | $249K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.