| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | ANTHEM LIFE INSURANCE COMPANY | $29K | — | $29K | 2.25% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE ROAD #300 INDEPENDENCE, OH 44131 | ANTHEM LIFE INSURANCE COMPANY | $441 | $200 | $641 | 0.05% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | COMMUNITY INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| ALPHA BENEFITS INC3 Filed as: ALPHA BENEFITS INC. | 4200 ROCKSIDE ROAD #300 INDEPNDENCE, OH 44131 | COMMUNITY INSURANCE COMPANY | $2K | — | $2K | 2.74% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE ROAD #300 INDEPENDENCE, OH 44131 | ANTHEM LIFE INSURANCE COMPANY | $198 | $4K | $5K | 7.87% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 2.60% |
| LEWIS P AGNONE3 | 731 PENHALE AVENUE CAMPBELL, OH 44405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 13.86% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK SERVICES CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 5.68% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC | 353 NORTH CLARK STREET CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.20% |
| AMDREW F VERBOSKY JR3 | 491 QUARRY LANE WARREN, OH 44483 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.11% |
| MICHAEL ROBERT YURCZYK3 Filed as: MICHAEL R YURCZYK | 111 WEST JACKSON BOULEVARD 17TH FLOOR CHICAGO, IL 60604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.91% |
| PAUL D QUILLIN3 | 955 WINDHAM COURT YOUNGSTOWN, OH 44512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.50% |
| THOMAS J HOUSER3 | 955 WINHAM COURT SUITE 4 BOARDMAN, OH 44512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $957 | — | $957 | 2.19% |
| JOHN H VRATSINAS3 | 1142 WEST MADISON SUITE 305 CHICAGO, IL 60607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $555 | — | $555 | 1.27% |
| ERIC KERR3 | 265 SUNSET DRIVE NORTHFIELD, IL 60093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $288 | — | $288 | 0.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8561 EAST AVENUE MENTOR, OH 44060 | CONTINENTAL AMERICAN INSURANCE COMPANY | $145 | — | $145 | 0.33% |
| BOR HOUSE ACCOUNT3 | P.O. BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $112 | — | $112 | 0.26% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 111 | $1.3M |
| Dental | COMMUNITY INSURANCE COMPANY | 141 | $91K |
| Vision | ANTHEM LIFE INSURANCE COMPANY | 111 | $1.3M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 147 | $57K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 147 | $57K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 147 | $57K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 147 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.