| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INDEMNITY GROUP LLC Filed as: INDEMNITY GROUP LLC | 3628 WALNUT HILLS BLVD. 200 BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GARY BONCELLA EMPLOYEE | Employee (plan) Service code 30 | 2297 LAMBERTON ROAD CLEVELAND HEIGHTS, OH 44118 | $137K |
| MAUREEN STAVOLE EMPLOYEE | Employee (plan) Service code 30 | 9689 GRIST MILL RUN OLMSTED FALLS, OH 44138 | $72K |
| CHRISSANN CHAMBERS EMPLOYEE | Employee (plan) Service code 30 | 7030 WESTVIEW DRIVE BRECKSVILLE, OH 44141 | $62K |
| THE SEGAL COMPANY EIN 13-1975125 ACTUARIAL SERVICES | Actuarial Service code 11 | — | $59K |
| DONNA SCAFARO EMPLOYEE | Employee (plan) Service code 30 | 6776 HATHAWAY ROAD VALLEY VIEW, OH 44125 | $28K |
| TRAMER, SHORE & ZWICK EIN 34-1736265 AUDITOR | Accounting (including auditing) Service code 10 | — | $18K |
| FAULKNER, HOFFMAN & PHILLIPS LLC EIN 45-1540483 LEGAL SERVICES | Legal Service code 29 | 20445 EMERALD PKWY 210 CLEVELAND, OH 44135 | $7K |
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 | 392 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 92 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 484 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED AMERICAN INSURANCE COMPANY | 107 | $440K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $36K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 248 | $11K |
| Prescription drug | UNITED AMERICAN INSURANCE COMPANY | 107 | $440K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 248 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 547 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.