| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TODD ASSOCIATES, INC.3 Filed as: TODD ASSOCIATES INC. | 23825 COMMERCE PARK RD. SUITE A BEACHWOOD, OH 44122 | HEALTHSPAN INTEGRATED CARE | $44K | — | $44K | 1.62% |
| EXPRESSLINK GENERAL AGENCY LLC3 | 4200 ROCKSIDE ROAD #103 CLEVELAND, OH 44131 | GUARDIAN | $11K | $8K | $19K | 10.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1100 SUPERIOR AVENUE EAST STE. 1700 CLEVELAND, OH 441142521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| RM BENEFIT CONSULTANTS, INC.3 Filed as: RM BENEFIT CONSULTANTS INC. | 30432 EUCLID AVENUE STE. 115 WICKLIFFE, OH 440921560 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $362 | — | $362 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CDS ADMINISTRATORS, INC. EIN 25-1352803 NONE | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | — | $37K |
| SCHWARZWALD & MCNAIR EIN 34-1327628 NONE | Legal Service code 29 | — | $36K |
| MALONEY & NOVOTNY LLC EIN 34-0677006 NONE | Accounting (including auditing) Service code 10 | — | $35K |
| G. WILK EIN 34-6529808 EMPLOYEE | Employee (plan) Service code 30 | — | $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 | 260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHSPAN INTEGRATED CARE | 284 | $2.7M |
| Dental | GUARDIAN | 284 | $186K |
| Vision | UNION EYE CARE | 267 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 267 | $18K |
| Prescription drug | HEALTHSPAN INTEGRATED CARE | 284 | $2.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 267 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.