| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 Filed as: UMR, INC | 11 SCOTT ST, STE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 0.67% |
| WILLIAM H. MEYER AGENCY, INC.3 Filed as: WILLIAM H MEYER AGENCY, INC. | 1660 NW PROFESSIONAL PLZ STE J COLUMBUS, OH 43220 | VISION SERVICE PLAN | $2K | — | $2K | 2.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Claims processing; Float revenue; Direct payment from the plan Service code 12 | — | $1.5M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $57K |
| PHELAN INSURANCE AGENCY INC EIN 34-0900043 BROKER | Other commissions Service code 55 | P.O. BOX 1 863 E MAIN ST VERSAILLES, OH 45380 | $41K |
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 VENDOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | — | $16K |
| CORNERSTONE BROKER INSURANCE EIN 31-1440175 BROKER | Other commissions; Insurance agents and brokers; Non-monetary compensation Service code 22 | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | $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 | 315 | 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) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 280 | $76K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 315 | $367K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
No prospect flags tripped on this filing.