| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES OH INC. | 4700 ROCKSIDE ROAD, STE 540 CLEVELAND, OH 44131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $7K | $19K | 14.47% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE ROAD, STE 540 SEVEN HILLS, OH 441312149 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE ROAD, STE 540 INDEPENDENCE, OH 44131 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 10.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 | Claims processing; Other services; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | 4361 IRWIN SIMPSON ROAD MASON, OH 45040 | $150K |
| EMPLOYEE BENEFITS INTERNATIONAL EIN 56-2676854 | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 4700 ROCKSIDE RD, SUITE 540 INDEPENDENCE, OH 44131 | $0 |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 | Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $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 | 262 | 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) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $128K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $128K |
| Life insurance(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $180K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $128K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 111 | $145K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $156K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.