| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORNERSTONE BROKER INS SERVICES Filed as: CORNERSTONE BROKER INS SERVICE AGEN | 2101 FLORENCE AVE CINCINNATI, OH 45206 | ANTHEM BLUE CROSS BLUE SHIELD | $0 | $6K | $6K | 4.07% |
| KPM INSURANCE LLC | 61 MARCO LANE CENTERVILLE, OH 45458 | ANTHEM BLUE CROSS BLUE SHIELD | $759 | $0 | $759 | 0.55% |
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO | 5880 VENTURE DRIVE DUBLIN, OH 43017 | COLONIAL LIFE & ACCIDENT INS COMP | $33 | $0 | $33 | 4.62% |
| HOWARD B MESZAROS | 8680 COLVIN DRIVE PLAIN CITY, OH 43064 | COLONIAL LIFE & ACCIDENT INS COMP | $2 | $0 | $2 | 0.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 1087 WAUSAU, WI 54402 | $156K |
| KPM INSURANCE LLC EIN 27-1251252 BROKER | Other commissions Service code 55 | 76 MARCO LANE CENTERVILLE, OH 45458 | $42K |
| COTTINGHAM & BUTLER INS SRVCS INC EIN 42-0198040 BROKER | Other commissions Service code 55 | 800 MAIN STREET DUBUQUE, IA 52001 | $25K |
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 | 713 | 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) | 713 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS BLUE SHIELD | 903 | $138K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS BLUE SHIELD | 903 | $138K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 713 | $259K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 713 | $259K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 903 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.