| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | MEDICAL MUTUAL | $38K | $12K | $49K | 3.74% |
| R L KING INSURANCE AGENCY INC3 Filed as: R L KING AGENCY INC | PO BOX 1265 HOLLAND, OH 43528 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $356 | $5K | 3.80% |
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF MIDWEST | 419 5TH ST STE 1200 DEFIANCE, OH 43512 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.47% |
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF MIDWEST | 419 5TH ST STE 1200 DEFIANCE, OH 43512 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.97% |
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | VISION SERVICE PLAN | $922 | $0 | $922 | 6.22% |
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | VISION SERVICE PLAN | $871 | $0 | $871 | 6.51% |
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF MIDWEST | 511 5TH ST DEFIANCE, OH 43512 | CONSUMERS LIFE INSURANCE COMPANY | $1K | $523 | $2K | 16.74% |
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 | 128 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 120 | $1.3M |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 446 | $151K |
| Vision(2 contracts) | VISION SERVICE PLAN | 91 | $28K |
| Life insurance | CONSUMERS LIFE INSURANCE COMPANY | 134 | $11K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 446 | $123K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 446 | $123K |
| Prescription drug | MEDICAL MUTUAL | 120 | $1.3M |
| Other | CONSUMERS LIFE INSURANCE COMPANY | 134 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 446 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.