| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST INC | 200 E. RANDOLPH ST CHICAGO, IL 60601 | DELTA DENTAL PLAN OF OHIO | $9K | — | $9K | 4.94% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST INC | 1660 W. 2ND ST. SUITE 650 CLEVELAND, OH 44113 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 8.39% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST, INC | 1660 W 2ND ST SUITE 650 CLEVELAND, OH 44113 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 8.40% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST, INC | 1660 W 2ND ST SUITE 650 CLEVELAND, OH 44113 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $203 | — | $203 | 5.00% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST INC | 200 E. RANDOLPH ST CHICAGO, IL 60601 | DELTA DENTAL OF OHIO | $168 | — | $168 | 5.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY (G1728) EIN 31-1440175 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Other services; Claims processing; Contract Administrator Service code 12 | 3350 PEACHTREE ROAD POB 30302-445 ATLANTA, GA 303261039 | $399K |
| AON RISK SERVICES NONE | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 1660 W SECOND STREET #650 CLEVELAND, OH 44113 | $0 |
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 | 533 | 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) | 533 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL PLAN OF OHIO | 692 | $194K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,018 | $130K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,018 | $130K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (G1728) DBA ANTHEM BLUE CROSS AND BLUE SHI | 496 | $799K |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,018 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,018 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.