| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | COMMUNITY INSURANCE COMPANY | $41K | $1K | $42K | 4.42% |
| ARCURI & ASSOC ASSUR AGCY INC.3 | 400 W RAILROAD ST. 6 COLUMBIANA, OH 44408 | COMMUNITY INSURANCE COMPANY | $203 | — | $203 | 0.02% |
| ALPHA BENEFITS INC3 Filed as: ALPHA BENEFITS INC. | 4200 ROCKSIDE RD 300 INDEPENDENCE, OH 44131 | COMMUNITY INSURANCE COMPANY | $81 | — | $81 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1111 SUPERIOR AVE. E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $41 | $12K | 9.20% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS INC. | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 4.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 2.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVIES INC. | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | — | $19 | $19 | 0.01% |
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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 209 | $947K |
| Dental(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 209 | $1.1M |
| Vision(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 209 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 209 | $1.1M |
| Short-term disability(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 209 | $1.1M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 180 | $135K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 180 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.