| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | MEDICAL MUTUAL OF OHIO | $22K | $25K | $47K | 2.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PARK CENTRAL Y 12750 MERIT DR., SUITE 1,000 DALLAS, TX 75251 | GUARDIAN INSURANCE | $26K | — | $26K | 10.10% |
| CGI VOLUNTARY BENEFITS, INC.3 | 20046 WALKER ROAD #5 CLEVELAND, OH 44121 | GUARDIAN INSURANCE | $663 | $10K | $11K | 4.25% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 142 | $2.2M |
| Dental | GUARDIAN INSURANCE | 256 | $253K |
| Vision | GUARDIAN INSURANCE | 256 | $253K |
| Life insurance | GUARDIAN INSURANCE | 256 | $253K |
| Short-term disability | GUARDIAN INSURANCE | 256 | $253K |
| Long-term disability | GUARDIAN INSURANCE | 256 | $253K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 142 | $2.2M |
| Other | GUARDIAN INSURANCE | 256 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 256 | — |
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.