| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASHLEY INSURANCE GROUP3 Filed as: ASHLEY INSURANCE GROUP LTD | 1645 INDIAN WOODS CIR STE 203 MAUMEE, OH 43537 | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | $17K | — | $17K | 0.93% |
| STEPHEN O BRYANT3 | 532 PRINCETON ROAD JOHNSON CITY, TN 37601 | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | $9K | — | $9K | 0.49% |
| BROKERNET INC3 | 110 NORTHWOOD BLVD STE C COLUMBUS, OH 43235 | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | $3K | — | $3K | 0.18% |
| MAY INSURANCE SERVICES INC3 | 110 NORTHWOODS BLVD STE C COLUMBUS, OH 43235 | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | $3K | — | $3K | 0.16% |
| WILLIAM T. WALBORN3 Filed as: WILLIAM T WALBORN | 10701 OBEE ROAD WHITEHOUSE, OH 43571 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 16.19% |
| ASHLEY INSURANCE GROUP3 Filed as: ASHLEY INSURANCE GROUP LTD | 1645 INDIAN WOODS CIR STE 203 MAUMEE, OH 43537 | ANTHEM LIFE INSURANCE COMPANY | $960 | — | $960 | 5.03% |
| STEPHEN O BRYANT3 | 532 PRINCETON ROAD JOHNSON CITY, TN 37601 | ANTHEM LIFE INSURANCE COMPANY | $871 | — | $871 | 4.56% |
| BROKERNET INC3 | 110 NORTHWOODS BLVD STE C COLUMBUS, OH 43235 | ANTHEM LIFE INSURANCE COMPANY | $131 | — | $131 | 0.69% |
| WILLIAM T. WALBORN3 Filed as: WILLIAM T WALBORN | 5640 SOUTHWICK BLVD STE 103 TOLEDO, OH 43614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
No Schedule C service providers reported on this filing.
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 123 | $1.9M |
| Dental | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 123 | $1.9M |
| Vision | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 123 | $1.9M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $85K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 106 | $66K |
| Prescription drug | COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 123 | $1.9M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.