| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REDTAIL LTD3 | 9999 BREWSTER LN STE 100 POWELL, OH 43065 | MEDICAL MUTUAL | $22K | $17K | $38K | 2.59% |
| REDTAIL LTD3 | 9999 BREWSTER PLACE #100 POWELL, OH 43065 | THE GUARDIAN LIFE INSURANCE COMPANY | $6K | — | $6K | 7.74% |
| REDTAIL LTD3 | 9999 BREWSTER LANE SUITE 100 POWELL, OH 43065 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.34% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $54 | $54 | 0.10% |
| REDTAIL LTD3 | 9999 BREWSTER PLACE #100 POWELL, OH 43065 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $5K | $9K | 17.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AME EIN 22-1211670 ADMIN SERVICES | Consulting fees Service code 70 | — | $3K |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 121 | $1.5M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $50K |
| Vision(3 contracts, 3 carriers) | MEDICAL MUTUAL | 333 | $1.6M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 154 | $55K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 333 | $127K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 333 | $132K |
| Prescription drug | MEDICAL MUTUAL | 121 | $1.5M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 333 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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.