| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVE E SUITE 1500 CLEVELAND, OH 44144 | DELTA DENTAL OF OHIO | $5K | — | $5K | 3.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMIN & RELATED SVC | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $407K |
| DELTA DENTAL OF OHIO EIN 31-0685339 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $18K |
| THE JAMES B OSWALD COMPANY AGENT/AGENCY | Insurance agents and brokers Service code 22 | 1100 SUPERIOR AVE SUITE 1500 CLEVELAND, OH 44114 | $5K |
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 | 682 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 682 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 643 | $162K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 682 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.