| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY | 3931 S DIXIE DRIVE DAYTON, OH 45439 | COMMUNITY INSURANCE COMPANY | $0 | $3K | $3K | 0.30% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY | 3931 S DIXIE DRIVE DAYTON, OH 45439 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $344 | $4K | 5.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 THIRD PARTY ADMINISTRATOR | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $651K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 PRESCIRPTION DRUG REBATES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $0 |
| MCGOHAN BRABENDER AGENCY EIN 31-1191330 INSURANCE BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | — | $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 | 1,460 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,655 | $71K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,655 | $71K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,655 | $71K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 2,058 | $904K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,655 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,058 | — |
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.