| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | SUMMACARE | $13K | — | $13K | 1.83% |
| NFK CORPORATE SERVICES3 | 6450 ROCKSIDE WOODS BLVD, SUITE 250 INDEPENDENCE, OH 44131 | SUMMACARE | $9K | — | $9K | 1.30% |
| DAVID CAMPANA INSURANCE LTD3 | 341 COPPER CREEK AMHERST, OH 44001 | COMPANION LIFE INSURANCE COMPANY | $6K | — | $6K | 14.60% |
| COVEY RUN INSURANCE LLC3 | 341 COPPER CREEK AMHERST, OH 44001 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 3.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 201 E FOURTH ST, SUITE 625 CINCINNATI, OH 45202 | GUARDIAN INSURANCE | $2K | $3K | $5K | 11.66% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES OH | 4700 ROCKSIDE ROAD, SUITE 540 CLEVELAND, OH 44131 | GUARDIAN INSURANCE | $2K | — | $2K | 4.03% |
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 | 98 | 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) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUMMACARE | 89 | $706K |
| Dental | GUARDIAN INSURANCE | 75 | $39K |
| Vision | GUARDIAN INSURANCE | 75 | $39K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 98 | $40K |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 98 | $40K |
| Long-term disability | COMPANION LIFE INSURANCE COMPANY | 98 | $40K |
| Other | COMPANION LIFE INSURANCE COMPANY | 98 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 98 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.