| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 441142521 | VISION SERVICE PLAN | $964 | — | $964 | 6.05% |
| BAC AGENCY, INC.5 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESS ADMINISTRATORS & CONS. INC THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | $65K |
| GALLAGHER BENEFIT SERVICES INSURANCE AGENT | Insurance agents and brokers Service code 22 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | $47K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NETWORK PROVIDER | Insurance services Service code 23 | — | $22K |
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 | 126 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIMERICA INSURANCE COMPANY | 126 | $344K |
| Vision | VISION SERVICE PLAN | 118 | $16K |
| Prescription drug | UNIMERICA INSURANCE COMPANY | 126 | $344K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 126 | $344K |
| Other | UNITED HEALTHCARE | 126 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.