| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN | 2307 EAST AURORA ROAD SUITE B13 TWINSBURG, OH 44087 | HCC LIFE ALLIED BENEFIT SYSTEM INC | $28K | — | $28K | 10.50% |
| CHAPMAN & CHAPMAN INC3 | 2307 E AURORA RD B-13 TWINSBURG, OH 44087 | GUARDIAN | $7K | — | $7K | 3.79% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN & CHAPMAN INC. | 2307 E. AURORA RD STE B13 TWINSBURG, OH 44087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15K | $1K | $16K | 19.44% |
| PAUL AMOS & ASSOCIATES LLC3 | 5311 MEADOW LN CT STE 4 SHEFFIELD VILLAGE, OH 44035 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.01% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TEXAS HWY BLDG 2, STE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $930 | $930 | 1.10% |
| LINDA JEAN FOX3 | 37366 WEXFORD DR. CLEVELAND, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 0.27% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN | 2307 EAST AURORA RD SUITE B-13 TWINSBURG, OH 44202 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 8.38% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN | 2307 E AURORA RD SUITE B-13 TWINSBURG, OH 44202 | TRUSTMARK INSURANCE COMPANY | $656 | — | $656 | 9.29% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN | 2307 EAST AURORA RD SUITE B-13 TWINSBURG, OH 44202 | TRUSTMARK INSURANCE COMPANY | $906 | — | $906 | 19.29% |
| CHAPMAN & CHAPMAN INC3 Filed as: CHAPMAN AND CHAPMAN | 2307 EAST AURORA RD SUITEB-13 TWINSBURG, OH 44202 | TRUSTMARK INSURANCE COMPANY | $21 | — | $21 | 7.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS INC. EIN 36-3086057 | Contract Administrator Service code 13 | — | $263K |
| AETNA EIN 06-6033492 | Insurance services Service code 23 | — | $22K |
| HEALTH CARE BLUE BOOK | Other services Service code 49 | 330 FRANKLIN ROAD SUITE 135A-428 BRENTWOOD, TN 37027 | $10K |
| TELADOC | Other services Service code 49 | 1945 LAKEPOINTE DRIVE LEWISVILLE, TX 75057 | $10K |
| AMERICAN HEALTH HOLDING | Insurance agents and brokers Service code 22 | 7400 W CAMPUS RD NEW ALBANY, OH 43054 | $8K |
| CURALINC | Insurance services Service code 23 | 4930 OAKTON STREET SUITE 400 SKOKIE, IL 60088 | $8K |
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 | 630 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 630 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE ALLIED BENEFIT SYSTEM INC | 630 | $265K |
| Dental | GUARDIAN | 588 | $178K |
| Vision | GUARDIAN | 588 | $178K |
| Life insurance(3 contracts, 3 carriers) | GUARDIAN | 588 | $276K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 203 | $85K |
| Long-term disability | GUARDIAN | 588 | $178K |
| Stop-loss / reinsurancereinsurance | HCC LIFE ALLIED BENEFIT SYSTEM INC | 630 | $265K |
| Other(3 contracts, 2 carriers) | GUARDIAN | 588 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 630 | — |
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.