| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SELF FUNDED PLANS AGENCY INC Filed as: SELF FUNDED PLANS | 1432 HAMILTON AVENUE CLEVELAND, OH 44114 | TOKIO MARINE HCC | $10K | — | $10K | 10.00% |
| INSURANCE PARTNERS AGENCY INC | 26865 CENTER RIDGE RD WESTLAKE, OH 44145 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $2K | $4K | 9.89% |
| SELF FUNDED PLANS AGENCY INC Filed as: SELF FUNDED PLANS | 1432 HAMILTON AVENUE CLEVELAND, OH 44114 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 10.17% |
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 | 543 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 543 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE CO | 553 | $498K |
| Dental | BERKLEY LIFE AND HEALTH INSURANCE CO | 543 | $398K |
| Vision | BERKLEY LIFE AND HEALTH INSURANCE CO | 543 | $398K |
| Life insurance(3 contracts, 3 carriers) | BERKLEY LIFE AND HEALTH INSURANCE CO | 638 | $459K |
| Short-term disability | BERKLEY LIFE AND HEALTH INSURANCE CO | 543 | $398K |
| Prescription drug | BERKLEY LIFE AND HEALTH INSURANCE CO | 543 | $398K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO | 543 | $398K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 638 | — |
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.