| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OBL INSURANCE SERVICES AGENCY INC.3 Filed as: OBL INSURANCE SERVICES AGENCY INC | 4215 WORTH AVE. SUITE 300 COLUMBUS, OH 43219 | RELIANCE STANDARD LIFE INSURANCE CO | $38K | $8K | $45K | 18.00% |
| OBL INSURANCE SERVICES AGENCY INC.3 | 4215 WORTH AVE. SUITE 300 COLUMBUS, OH 43219 | RELIANCE STANDARD LIFE INSURANCE CO | $25K | $5K | $30K | 18.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESSOLVERS EIN 42-1053807 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $185K |
| DIAMOND CONSULTING GROUP EIN 45-5006498 NONE | Actuarial Service code 11 | — | $156K |
| CONSOLIPLEX EIN 46-1778400 NONE | Consulting fees Service code 70 | — | $144K |
| MALONEY + NOVOTNY,LLC EIN 34-0677006 NONE | Accounting (including auditing) Service code 10 | — | $42K |
| VORYS, SATER, SEYMOUR & PEASE LLP EIN 31-4333125 NONE | Legal Service code 29 | — | $13K |
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 | 2,664 | 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) | 2,664 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,017 | $387K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE CO | 1,690 | $421K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 2,660 | $2.4M |
| Other | RELIANCE STANDARD LIFE INSURANCE CO | 1,690 | $252K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,660 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.