| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R L KING INSURANCE AGENCY INC3 Filed as: R L KING INSURANCE AGENCY, INC. | PO BOX 1265 7723 AIRPORT HIGHWAY, SUITE F HOLLAND, OH 435287602 | MEDICAL MUTUAL OF OHIO | $77K | $5K | $83K | 22.55% |
| R L KING INSURANCE AGENCY INC3 | 7723 AIRPORT HIGHWAY SUITE F HOLLAND, OH 43528 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | — | $13K | 10.47% |
| DMC BENEFITS INC3 Filed as: DMC BENEFITS INC. | 1485 PRINCE CHARLES AVE. WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 5.00% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY, INC | 3008 ATKINSON AVE LEXINGTON, KY 40509 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.54% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 1265 HOLLAND, OH 43528 | VISION SERVICE PLAN | $1K | — | $1K | 4.38% |
| R L KING INSURANCE AGENCY INC3 Filed as: R L KING INSURANCE AGENCY | PO BOX 1265 HOLLAND, OH 435281265 | VISION SERVICE PLAN | $539 | — | $539 | 2.35% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 20.00% |
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 | 269 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 226 | $23K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $125K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 212 | $367K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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.