| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | COMMUNITY INSURANCE COMPANY | $10K | — | $10K | 3.00% |
| FIRST MERCHANTS INSURANCE SERVICES3 | 302 EAST JACKSON STREET MUNCIE, IN 47305 | COMMUNITY INSURANCE COMPANY | $405 | $3K | $4K | 1.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | COMMUNITY INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER,INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | GUARDIAN | $2K | $1K | $3K | 14.88% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | VSP | $946 | — | $946 | 6.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | COMMUNITY INSURANCE COMPANY | $306 | — | $306 | 2.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Contract Administrator Service code 12 | — | $69K |
| EXPRESS SCRIPTS EIN 31-1714795 PHARMACY MANAGER | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $650 |
| MCGOHAN BRABENDER, INC. EIN 31-1191330 BROKER | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other commissions Service code 22 | — | $0 |
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 | 287 | 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) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 287 | $319K |
| Dental(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 239 | $96K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 239 | $38K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 287 | $36K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 429 | $236K |
| Other | GUARDIAN | 239 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.