| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ART HAUSER INSURANCE INC3 | 8620 NORTHCREEK DR., STE. 200 CINCINNATI, OH 45236 | UNITEDHEALTHCARE INSURANCE COMPANY | $836 | $9K | $10K | 1.93% |
| BCI GROUP, INC.3 Filed as: BCI GROUP INC | 6979 SE LAKE RD PORTLAND, OR 97267 | UNITEDHEALTHCARE INSURANCE COMPANY | $303 | $5K | $5K | 1.02% |
| ART HAUSER INSURANCE INC3 Filed as: ART HAUSER INS INC | 8260 NORTHCREEK DR, STE. 200 CINCINNATI, OH 45236 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.52% |
| BCI GROUP, INC.3 Filed as: BCI GROUP INC | 6979 SE LAKE RD PORTLAND, OR 97267 | SUN LIFE ASSURANCE COMPANY OF CANADA | $519 | — | $519 | 0.80% |
| BCI GROUP, INC.3 Filed as: BCI GROUP INC | 6967 SE LAKE RD PORTLAND, OR 97267 | SUN LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | — |
| HAUSER INC3 | 8260 NORTHCREEK DR, STE. 200 CINCINNATI, OH 45236 | SUN LIFE AND HEALTH INSURANCE COMPANY | $204 | — | $204 | — |
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 | 205 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 205 | $514K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 107 | $65K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY | 108 | $0 |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY | 108 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.