| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRITY INSURANCE SOLUTIONS3 | 44 STURGES AVENUE MANSFIELD, OH 44902 | MEDMUTUAL LIFE INSURANCE COMPANY | $717 | $299 | $1K | 8.29% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | MEDMUTUAL LIFE INSURANCE COMPANY | $735 | — | $735 | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 STOP LOSS | Claims processing Service code 12 | — | $492K |
| MEDICAL MUTUAL SERVICES EIN 34-1922587 ADMIN | Plan Administrator Service code 14 | — | $210K |
| INTEGRITY INSURANCE SOLUTIONS BROKER | Insurance agents and brokers Service code 22 | — | $91K |
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 | 434 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDMUTUAL LIFE INSURANCE COMPANY | 545 | $12K |
| Dental | MEDMUTUAL LIFE INSURANCE COMPANY | 545 | $12K |
| Stop-loss / reinsurancereinsurance | MEDMUTUAL LIFE INSURANCE COMPANY | 545 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 545 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.