| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REDTAIL LTD3 | 9999 BREWSTER PLACE #100 POWELL, OH 43065 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $760 | $5K | 6.79% |
| THOMPSON BENEFIT SOLUTIONS INC.3 | 2036 W. FOURTH STREET MANSFIELD, OH 44906 | ANTHEM LIFE INSURANCE COMPANY | $891 | $0 | $891 | 10.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $48K |
| THOMPSON BENEFIT SOLUTIONS INC. EIN 20-8075654 BROKER | Other commissions Service code 55 | 2036 W. 4TH STREET MANSFIELD, OH 44906 | $14K |
| REDTAIL LTD EIN 31-1460617 BROKER | Other commissions Service code 55 | 9999 BREWSTER LN #100 POWELL, OH 43065 | $5K |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $74K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $74K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 111 | $8K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 76 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
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.