| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REDTAIL LTD3 | 9999 BREWSTER LN STE 100 POWELL, OH 43065 | MEDICAL MUTUAL | $22K | $15K | $37K | 2.48% |
| REDTAIL LTD3 | 9999 BREWSTER PLACE #100 POWELL, OH 43065 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.44% |
| LIFETIME FINANCIAL GROWTH3 Filed as: LIFETIME FINANCIAL GROWTH CO | 38 PLUM STREET STE 100 CINCINNATI, OH 45202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 0.00% |
| REDTAIL LTD3 | 9999 BREWSTER LANE SUITE 100 POWELL, OH 43065 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.50% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $58 | $58 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AME EIN 22-1211670 ADMIN SERVICES | Consulting fees Service code 70 | — | $6K |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 123 | $1.5M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $86K |
| Vision(2 contracts, 2 carriers) | MEDICAL MUTUAL | 123 | $1.6M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 147 | $74K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $86K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 147 | $74K |
| Prescription drug | MEDICAL MUTUAL | 123 | $1.5M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 147 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.