| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA RD STE B-13 TWINSBURG, OH 44087 | UNITEDHEALTHCARE INSURANCE COMPANY | $18K | — | $18K | 7.00% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 E AURORA RD B13 TWINSBURG, OH 440871952 | HARTFORD LIFE AND ACCIDENT | $20K | — | $20K | 14.97% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN INC | 2307 EAST AURORA RD SUITE B-13 TWINSBURG, OH 44087 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT. | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $424K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $163K |
| CHAPMAN & CHAPMAN INC EIN 34-6527423 BROKER | Other commissions Service code 55 | — | $78K |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 610 | $262K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 610 | $262K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 321 | $136K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 321 | $136K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 257 | $368K |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 321 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 610 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.