| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY, INC. | 3931 S. DIXIE DR DAYTON, OH 45439 | STANDARD INSURANCE COMPANY | $33K | — | $33K | 12.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | ATTN ANN INGRAM PO BOX 62889 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $16K | — | $16K | 5.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY, INC. | 3931 S DIXIE DR DAYTON, OH 45439 | STANDARD INSURANCE COMPANY | $25K | — | $25K | 14.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | ATTN ANN INGRAM PO BOX 62889 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 5.54% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY, INC. | 3931 S. DIXIE DR. DAYTON, OH 45439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $824 | $14K | 11.74% |
| JUSTIN S PETER3 Filed as: JUSTIN S. PETER | 4665 CORNELL RD., STE. 331 CINCINNATI, OH 45241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $665K |
| MCGOHAN BRABENDER AGENCY, INC. EIN 31-1191330 NONE | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $40K |
| USI MIDWEST, LLC EIN 31-0507943 NONE | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $29K |
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 | 1,050 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,091 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 995 | $708K |
| Dental | COMMUNITY INSURANCE COMPANY | 995 | $708K |
| Vision | VISION SERVICE PLAN | 584 | $138K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,050 | $276K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,050 | $170K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 995 | $708K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 376 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,050 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.