| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEDICAL MUTUAL OF OHIO3 | 2060 EAST NINTH STREET CLEVELAND, OH 44115 | MEDICAL MUTUAL OF OHIO | — | $463K | $463K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 INSURANCE PROVIDER | Employee (plan); Claims processing Service code 12 | 2060 EAST NINTH STREET CLEVELAND, OH 44115 | $142K |
| IBEW LOCAL NO. 129 FRINGE BENEFITS EIN 34-1841503 BENEFIT ADMINISTRATION | Plan Administrator Service code 14 | 2235 WEST PARK DRIVE SUITE B LORAIN, OH 44053 | $111K |
| FINDLEY DAVIES EIN 34-1213174 ACTUARIAL CONSULTANTS | Actuarial Service code 11 | 1300 EAST NINTH ST., SUITE 850 CLEVELAND, OH 44114 | $46K |
| ALLOTTA FARLEY CO LPA EIN 34-1316963 LEGAL COUNSEL | Legal Service code 29 | 2222 CENTENNIAL ROAD TOLEDO, OH 43617 | $20K |
| FIFTH THIRD INSTITUTIONAL SERVICES EIN 31-1051736 INVESTMENT ADVISOR | Trustee (individual) Service code 20 | 600 SUPERIOR AVE EAST CLEVELAND, OH 44114 | $12K |
| ALAN JANUZZI, CPA EIN 34-1631968 INDEPENDANT AUDITOR | Accounting (including auditing) Service code 10 | 7710 RICE ROAD AMHERST, OH 44001 | $9K |
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 | 295 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 163 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 473 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Dental | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Vision | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Life insurance | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Short-term disability | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 456 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 456 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.