| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT M NICKOSON3 Filed as: ROBERT M. NICKOSON FINANCIAL GROUP | 30 NORTHWEST AVENUE BUILDING B SUITE 111 TALLMADGE, OH 44278 | AULTCARE INSURANCE COMPANY | $12K | — | $12K | 1.57% |
| GREENWALD UNDERWRITING3 | 5771 MAYFAIR ROAD NORTH CANTON, OH 44720 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $929 | — | $929 | 2.93% |
| ROBERT M NICKOSON3 | 30B NORTHWEST AVENUE SUITE 111 TALLMADGE, OH 44278 | THE EPIC LIFE INSURANCE COMPANY | $1K | — | $1K | 8.79% |
| BROADSTREET BROKERAGE INS AGENCY3 | 471 EAST BROAD STREET 10TH FLOOR COLUMBUS, OH 43215 | THE EPIC LIFE INSURANCE COMPANY | $607 | — | $607 | 4.79% |
| ROBERT M NICKOSON3 Filed as: ROBERT M. NICKOSON | 30 NORTHWEST AVENUE BUILDING B SUITE 111 TALMADGE, OH 44278 | VISION SERVICE PLAN | $425 | — | $425 | 4.45% |
| ROBERT M NICKOSON3 | 30B NORTHWEST AVENUE SUITE 111 TALLMADGE, OH 44278 | THE EPIC LIFE INSURANCE COMPANY | $378 | — | $378 | 9.01% |
| BROADSTREET BROKERAGE INS AGENCY3 | 471 EAST BROAD STREET 10TH FLOOR COLUMBUS, OH 43215 | THE EPIC LIFE INSURANCE COMPANY | $210 | — | $210 | 5.00% |
No Schedule C service providers reported on this filing.
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AULTCARE INSURANCE COMPANY | 175 | $743K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $32K |
| Vision | VISION SERVICE PLAN | 102 | $10K |
| Life insurance(2 contracts) | THE EPIC LIFE INSURANCE COMPANY | 136 | $17K |
| Other(2 contracts) | THE EPIC LIFE INSURANCE COMPANY | 136 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.