| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST STE 300 ROCKY RIVER, OH 44116 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | — | $4K | $4K | 0.35% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST STE 300 ROCKY RIVER, OH 44116 | HARTFORD LIFE AND ACCIDENT | $9K | — | $9K | 5.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO LLC | 1340 DEPOT ST STE 300 ROCKY RIVER, OH 441161741 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.64% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO | 1340 DEPOT ST ROCKY RIVER, OH 44116 | DELTA DENTAL OF OHIO | $3K | — | $3K | 5.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSUREDPARTNERS OF OHIO LLC BROKER | Insurance brokerage commissions and fees Service code 53 | 1340 DEPOT STREET STE 300 ROCKY RIVER, OH 44116 | $77K |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 3 | $16K |
| Dental | DELTA DENTAL OF OHIO | 272 | $56K |
| Vision | VISION BENEFITS OF AMERICA | 137 | $4K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 324 | $60K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $14K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 324 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.