| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RM BENEFIT CONSULTANTS, INC.3 | 6101 CENTER ST, UNIT 106 MENTOR, OH 44060 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $29K | $29K | 1.50% |
| RM BENEFIT CONSULTANTS, INC.3 | 6101 CENTER ST, UNIT 106 MENTOR, OH 44060 | COMMUNITY INSURANCE COMPANY | $5K | — | $5K | 7.05% |
| RM BENEFIT CONSULTANTS, INC.3 | 6101 CENTER ST, UNIT 106 MENTOR, OH 44060 | 5STAR LIFE INSURANCE COMPANY | $7K | — | $7K | 27.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL I. | 1125 17TH ST. SUTIE 900 DENVER, CO 80202 | 5STAR LIFE INSURANCE COMPANY | $8 | — | $8 | 0.03% |
| RM BENEFIT CONSULTANTS, INC.3 | 6101 CENTER ST, UNIT 106 MENTOR, OH 44060 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $830 | — | $830 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Claims processing Service code 12 | 33 FITCH BLVD. AUSTINTOWN, OH 44515 | $35K |
| MCDONALD PARTNERS EIN 20-2714559 NONE | Other services; Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Investment advisory (plan); Direct payment from the plan; Other investment fees and expenses Service code 15 | 1301 E. 9TH ST 3700 CLEVELAND, OH 44114 | $17K |
| BARNES WENDLING CPAS, INC. EIN 34-1463411 NONE | Accounting (including auditing) Service code 10 | 1350 EUCLID AVENUE, SUITE 1400 CLEVELAND, OH 44114 | $16K |
| FRANTZ WARD LLP. EIN 34-1906425 NONE | Insurance agents and brokers Service code 22 | 200 PUBLIC SQUARE SUITE 3000 CLEVELAND, OH 44114 | $6K |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 125 | $1.9M |
| Dental | COMMUNITY INSURANCE COMPANY | 132 | $65K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 134 | $8K |
| Life insurance | 5STAR LIFE INSURANCE COMPANY | 266 | $24K |
| Other | 5STAR LIFE INSURANCE COMPANY | 266 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.