| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KNAPSCHAEFER INSURANCE AGENCY3 Filed as: KNAPSCHAEFER INSURANCE | 213 W. MAIN ST COLDWATER, OH 45828 | SYMETRA LIFE INSURANCE COMPANY | $838 | — | $838 | 9.42% |
| MEDICAL BENEFITS ADMINISTRATORS5 Filed as: MEDICAL BENEFITS ADMINSTRATORS INC | 1975 TAMARACK RD NEWARK, OH 43058 | SYMETRA LIFE INSURANCE COMPANY | $733 | — | $733 | 8.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINSTRATORS INC EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | 1975 TAMARACK RD NEWARK, OH 43055 | $62K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 CONTRACT | Other fees Service code 99 | L-3956 COLUMBUS, OH 43260 | $19K |
| KNAPSCHAEFER INSURANCE EIN 34-1636464 BROKER | Insurance agents and brokers Service code 22 | 213 W. MAIN ST COLDWATER, OH 45828 | $16K |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 127 | $9K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 127 | $522K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 127 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.