| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP | 511 FIFTH STREET DEFIANCE, OH 43512 | ACE AMERICAN INSURANCE COMPANY | $52K | — | $52K | 15.00% |
| FISHCO INC3 | 227 NORTH LYNN STREET BRYAN, OH 43506 | ANTHEM LIFE INSURANCE COMPANY | $8K | — | $8K | 12.07% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INS SERVICES AGE | 2101 FLORENCE AVE CINCINNATI, OH 45206 | ANTHEM LIFE INSURANCE COMPANY | $150 | — | $150 | 0.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX RISK MANAGEMENT SERVICES LLC EIN 83-0360667 NONE | Consulting (general) Service code 16 | 190 US ROUTE 1 FALMOUNT, ME 04105 | $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 | 612 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 612 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ACE AMERICAN INSURANCE COMPANY | 462 | $349K |
| Dental | ACE AMERICAN INSURANCE COMPANY | 462 | $349K |
| Vision | ACE AMERICAN INSURANCE COMPANY | 462 | $349K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 542 | $63K |
| Short-term disability | ACE AMERICAN INSURANCE COMPANY | 462 | $349K |
| Prescription drug | ACE AMERICAN INSURANCE COMPANY | 462 | $349K |
| Stop-loss / reinsurancereinsurance | ACE AMERICAN INSURANCE COMPANY | 462 | $349K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 542 | — |
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.