| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OBL INSURANCE SERVICES AGENCY INC.3 Filed as: OBL INSURANCE SERVICES AGENCY | 4215 WORTH AVENUE, SUITE 300 COLUMBUS, OH 432191546 | AETNA LIFE INSURANCE COMPANY | $558 | $0 | $558 | 4.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Insurance agents and brokers; Contract Administrator Service code 13 | — | $1.3M |
| DIAMOND CONSULTING GROUP EIN 45-5006498 ACTUARY | Actuarial Service code 11 | — | $98K |
| BUSINESSOLVERS EIN 42-1053807 BILLING AND ELIGIBILITY | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $78K |
| HIRTH NORRIS AND GARRISON EIN 31-1158488 AUDITOR | Accounting (including auditing) Service code 10 | — | $37K |
| THE HUNTINGTON TRUST EIN 31-0966785 INVESTMENT ADVISORY | Investment advisory (plan) Service code 27 | — | $36K |
| HUNTINGTON NATIONAL BANK EIN 31-4272225 BANK FEES AND CHARGES | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $15K |
| OHIO DEPARTMENT OF INSURANCE EIN 31-6402047 LICENSE, EXAM FEES | Accounting (including auditing) Service code 10 | — | $14K |
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 | 1,322 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 858 | $176K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 1,302 | $151K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 1,322 | $799K |
| Other | AETNA LIFE INSURANCE COMPANY | 1,302 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,322 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.