| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MUTUAL HEALTH SERVICES5 | PO BOX 5700 CLEVELAND, OH 44101 | MEDICAL MUTUAL OF OHIO | — | $424K | $424K | 73.38% |
| HEALTHCARE STRAGETIS0 Filed as: HEALTHCARE STRATEGIES | 2060 EAST NINTH STREET CLEVELAND, OH 44115 | MEDICAL MUTUAL OF OHIO | — | $187K | $187K | 32.38% |
| WILLIS TOWERS WATSON US LLC0 Filed as: WILLIS OF OHIO, INC. | 200 PUBLIC SQUARE SUITE 3760 BP TOWER CLEVELAND, OH 44114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $39K | — | $39K | 8.00% |
| WILLIS TOWERS WATSON US LLC0 Filed as: WILLIS OF OHIO, INC. | 200 PUBLIC SQUARE SUITE 3760 BP TOWER CLEVELAND, OH 44114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $2K | $22K | 7.74% |
| WILLIS TOWERS WATSON US LLC0 Filed as: WILLIS OF OHIO, INC. | 200 PUBLIC SQUARE SUITE 3760 BP TOWER CLEVELAND, OH 44114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $305 | $3K | 7.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSUR COMPANY CLAIM ADMINISTRATOR | Float revenue; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | A CIGNA COMPANY HARTFORD, CT 06152 | $73K |
| TOTAL ADMIN SERVICE CORP (TASC) CLAIM ADMINISTRATOR | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 537043140 | $27K |
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 | 1,465 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY & AFFILIATES | 187 | $72K |
| Vision | EYEMED VISION CARE | 2,298 | $159K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 122 | $162K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,376 | $482K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,376 | $482K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 1,465 | $578K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,373 | $393K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,298 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.