| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 580 NORTH 4TH STREET SUITE 400 COLUMBUS, OH 432152106 | RELIANCE STANDARD LIFE INSURNACE COMPANY | $5K | — | $5K | 12.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | 1975 TAMARACK ROAD P O BOX 1009 NEWARK, OH 430581009 | $37K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 CONTRACT | Other fees Service code 99 | — | $14K |
| MEDICAL BENEFITS MUTUAL LIFE INS CO EIN 31-4210910 CONTRACT | Plan Administrator Service code 14 | — | $5K |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIANCE STANDARD LIFE INSURNACE COMPANY | 110 | $41K |
| Long-term disability | RELIANCE STANDARD LIFE INSURNACE COMPANY | 110 | $41K |
| Stop-loss / reinsurancereinsurance | AMERICAN ALTERNATIVE/MUNICH | 114 | $306K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.