| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARBO INSURANCE SRVCS USA | PO BO 203308 DALLAS, TX 75320 | MEDICAL MUTUAL | $39K | $29 | $39K | 2.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARBO INSURANCE SRVCS USA | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 7.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARBO INSURANCE SRVCS USA | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.47% |
| RICHARD CLOSE3 | 3656 LAKESTONE CIRCLE HILLIARD, OH 43026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $100 | $0 | $100 | 3.30% |
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO3 Filed as: INTEGRATED EMPLOYEE BEN. SOLUTIONS | 5880 VENTURE DRIVE DUBLIN, OH 43017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 0.96% |
| HARLEY J MURRAY3 | 705 NORTH STATE STREET WESTERVILLE, OH 43082 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.73% |
| HEALTHCARE REFORM ALTERNATIVES LLC3 | 2706 BAR HARBOUR COURT LEWIS CENTER, OH 43035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.26% |
No Schedule C service providers reported on this filing.
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 | 163 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 163 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 314 | $101K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 319 | $21K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 8 | $3K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 8 | $3K |
| Prescription drug | MEDICAL MUTUAL | 163 | $1.3M |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 8 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.