| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE FEDELI GROUP3 Filed as: THE FEDELI GROUP INC | 5005 ROCKSIDE RD INDEPENDENCE, OH 44131 | DELTA DENTAL OF OHIO | $52K | — | $52K | 6.44% |
| THE FEDELI GROUP3 Filed as: THE FEDELI GROUP INC | 5005 ROCKSIDE RD INDEPENDENCE, OH 44131 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $798 | $16K | 8.69% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $524 | $10K | 5.19% |
| THE FEDELI GROUP3 Filed as: THE FEDELI GROUP INC | 5005 ROCKSIDE RD INDEPENDENCE, OH 44131 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 6.22% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $351 | $7K | 3.72% |
| THE FEDELI GROUP3 Filed as: THE FEDELI GROUP INC | 5005 ROCKSIDE RD INDEPENDENCE, OH 44131 | VISION SERVICE PLAN | $4K | — | $4K | 2.13% |
| THE FEDELI GROUP3 Filed as: THE FEDELI GROUP INC | 5005 ROCKSIDE RD INDEPENDENCE, OH 44131 | SUN LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 9.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY | Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $403K |
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 | 2,020 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,020 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 4,386 | $801K |
| Vision | VISION SERVICE PLAN | 1,277 | $167K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,355 | $124K |
| Short-term disability(5 contracts, 5 carriers) | DELTA DENTAL OF OHIO | 4,386 | $1.2M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 4,902 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,902 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.