| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELTA BENEFITS AGENCY LLC3 | 4600 ROCKSIDE ROAD SUITE 200 INDEPENDENCE, OH 44131 | MEDICAL MUTUAL OF OHIO | $60K | $5K | $65K | 1.60% |
| LEONARD INSURANCE SERVICES AGENCY3 Filed as: LEONARD INSURANCE | PO BOX 9160 CANTON, OH 44711 | NATIONAL GUARDIAN LIFE | $10K | — | $10K | 12.00% |
| ONE AMERICA SECURITIES INC3 | PO BOX 368 INDIANAPOLIS, ID 46206 | NATIONAL GUARDIAN LIFE | $222 | — | $222 | 0.28% |
| DELTA BENEFITS AGENCY LLC3 | 4600 RCKSIDE ROAD SUITE 200 INDEPENDENCE, OH 44131 | CONSUMERS LIFE INSURANCE COMPANY | $5K | $3K | $8K | 12.44% |
| SIGMA II INS AGENCY3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $4K | 10.02% |
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 | 400 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 566 | $37K |
| Vision | NATIONAL GUARDIAN LIFE | 490 | $80K |
| Life insurance | CONSUMERS LIFE INSURANCE COMPANY | 568 | $64K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 566 | $37K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 505 | $4.1M |
| Other | CONSUMERS LIFE INSURANCE COMPANY | 568 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 568 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.