| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BILL DEMORAY3 | 1487 COURTYARD PL CENTERVILLE, OH 45458 | COMPANION LIFE | $24K | $0 | $24K | 10.90% |
| THE UNDERWRITERS GROUP INC3 Filed as: UNDERWRITERS SAFETY & CLAIMS | 11405 PARK RD. LOUISVILLE, KY 40223 | COMPANION LIFE | $13K | $0 | $13K | 6.05% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 Filed as: DEMORAY BENEFIT ADMINISTRATORS INC. | 1487 COURTYARD PL CENTERVILLE, OH 45458 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONAL UNION FIRE INSUR. CO. EIN 25-0687550 NONE | Other services Service code 49 | — | $29K |
| UNDERWRITER SERVICE CORP EIN 90-0345133 NONE | Claims processing Service code 12 | 11045 PARK RD LOUISVILLE, KY 40223 | $26K |
| HEALTHSMART EIN 75-2508316 NONE | Other services Service code 49 | TOWER AT ERIEVIEW, 24TH FLOOR 1301 EAST 9TH ST CLEVELAND, OH 44114 | $11K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Other services Service code 49 | — | $9K |
| GLOBAL CARE/ENCORE & COFINITY EIN 31-1407689 NONE | Other services Service code 49 | — | $3K |
| FIRST HEALTH EIN 20-1736437 NONE | Other services Service code 49 | — | $543 |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE | 138 | $219K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 152 | $16K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE | 138 | $219K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 152 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.