| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC Filed as: CORPORATE ONE BENEFITS AGCY INC. | P O BOX 906 FOSTORIA, OH 44830 | HCCB | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | P.O. BOX 1009 NEWARK, OH 43058 | $64K |
| CORPORATE ONE BENEFITS EIN 34-1834526 BROKER | Insurance agents and brokers Service code 22 | P.O. BOX 906 FOSTORIA, OH 44830 | $45K |
| OHIO HEALTH CHOICE EIN 34-1381358 CONTRACT | Other fees Service code 99 | P.O. BOX 2090 AKRON, OH 443092090 | $38K |
| QUALITY CARE PARTNERS EIN 31-1435370 CONTRACT | Other fees Service code 99 | 33 S. 5TH STREET ZANESVILLE, OH 43701 | $8K |
| MEDICAL BENEFITS MUTUAL LIFE INS CO EIN 31-4210910 CONTRACT | Plan Administrator Service code 14 | P.O. BOX 1009 NEWARK, OH 43058 | $7K |
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 | 246 | 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) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCCB | 246 | $275K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.