| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAC AGENCY, INC.5 Filed as: BAC AGENCY | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESS ADMINISTRATORS & CONS. INC CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 6331 EAST LIVINGSTON AVE REYNOLDSBURG, OH 43068 | $88K |
| MAGIS INSURANCE GROUP, LLC BROKER | Insurance agents and brokers Service code 22 | 36711 AMERICAN WAY SUITE 2-F AVON, OH 44011 | $41K |
| CLARITY HEALTH INC NETWORK PROVIDER | Insurance services Service code 23 | 1923 SPERRYS FORGE TRAIL WESTLAKE, OH 44145 | $26K |
| LD&B CONSULTANT | Consulting (general) Service code 16 | 205 SOUTH LIBERTY STREET HARRISONBURG, VA 22801 | $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 | 145 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 145 | $306K |
| Prescription drug(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 145 | $306K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 145 | $306K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 145 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.