| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROOKS INSURANCE AGENCY3 | 1120 MADISON AVE. TOLEDO, OH 43604 | DELTA DENTAL OF OHIO | $12K | — | $12K | 2.00% |
| BROOKS INS AGENCY INC3 | 1120 MADISON AVE. TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $354 | $10K | 4.62% |
| BROOKS INS AGENCY INC3 | 1120 MADISON AVE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36K | $4K | $40K | 19.42% |
| BROOKS INS AGENCY INC3 | 1120 MADISON AVE. TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $887 | $19K | 15.71% |
| BROOKS INS AGENCY INC3 | 1120 MADISON AVE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $93 | $2K | 15.75% |
| BROOKS INSURANCE AGENCY3 Filed as: BROOKS INSURANCE AGENCY INC. | 1120 MADISON AVENUE TOLEDO, OH 43604 | ACE AMERICAN INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 SERVICE PROVIDER | Other fees; Contract Administrator; Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $507K |
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 | 713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 741 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 1,544 | $466K |
| Dental | DELTA DENTAL OF OHIO | 1,601 | $587K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,217 | $434K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,217 | $227K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,217 | $239K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 1,544 | $466K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,217 | $563K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,601 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.