| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 4500 TOWN CENTER BOULEVARD SUITE 200 JEFFERSONVILLE, IN 47130 | COMMUNITY INSURANCE COMPANY | $37K | $3K | $39K | 2.72% |
| ASSUREDPARTNERS3 | 3900 KINROSS LAKES PARKWAY SUITE 300 RICHFIELD, OH 44286 | COMMUNITY INSURANCE COMPANY | $12K | $0 | $12K | 0.84% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN MARQUIS AGENCY, INC. | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | $1K | $0 | $1K | 0.10% |
| ASSUREDPARTNERS3 | 4500 TOWN CENTER BOULEVARD SUITE 200 JEFFERSONVILLE, IN 47130 | ANTHEM LIFE INSURANCE COMPANY | $3K | $253 | $3K | 11.55% |
| ANDREW INSURANCE ASSOCIATES INC3 Filed as: ANDREW INSURANCE ASSOCIATES | 9912 BREWSTER LANE POWELL, OH 43065 | ANTHEM LIFE INSURANCE COMPANY | $824 | $0 | $824 | 3.04% |
| BROCKERNET, INC3 | 110 NORTHWOODS BOULEVARD, SUITE C COLUMBUS, OH 43235 | ANTHEM LIFE INSURANCE COMPANY | $0 | $131 | $131 | 0.48% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 241 | $1.4M |
| Dental | COMMUNITY INSURANCE COMPANY | 241 | $1.4M |
| Vision | COMMUNITY INSURANCE COMPANY | 241 | $1.4M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 162 | $27K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 241 | $1.4M |
| Other | ANTHEM LIFE INSURANCE COMPANY | 162 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.