| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUMANA INSURANCE COMPANY | P.O. BOX 740036 LOUISVILLE, KY 402017436 | HUMANA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM EIN 31-1440175 NONE | Direct payment from the plan; Claims processing Service code 12 | 220 VIRGINIA AVE INDIANAPOLIS, IN 46204 | $241K |
| SOLXSYS ADMINISTRATIVE SOLUTIONS EIN 83-2454243 NONE | Direct payment from the plan; Plan Administrator Service code 14 | 5600 NEW KING DR, STE 330 TROY, MI 48098 | $160K |
| DGPERRY, PLLC EIN 83-3033790 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 3711 STARRS CENTRE DR CANFIELD, OH 44406 | $53K |
| ALLOTTA FARLEY CO LPA EIN 34-1316963 NONE | Legal; Direct payment from the plan Service code 29 | 3240 LEVIS COMMONS BLVD PERRYSBURG, OH 43551 | $53K |
| SEGAL GROUP, INC EIN 06-0839113 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $52K |
| IFEBP NONE | Other fees; Direct payment from the plan Service code 50 | 18700 W. BLUEMOND ROAD BROOKFIELD, WI 53045 | $9K |
| MARC SCHUESZLER TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 5600 NEW KING DRIVE TROY, MI 48098 | $6K |
| ANCORA EIN 33-1033773 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | 6060 PARKLAND BLVD 200 CLEVELAND, OH 44124 | $6K |
| MICHAEL RUSSELLE TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 5600 NEW KING DRIVE TROY, MI 48098 | $5K |
| KEY BANK NATIONAL ASSOCIATION EIN 34-0797057 NONE | Custodial (securities); Investment management fees paid indirectly by plan; Investment management Service code 19 | 100 PUBLIC SQUARE CLEVELAND, OH 44113 | $5K |
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 | 316 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 168 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 484 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | COMMUNITY INSURANCE COMPANY | 523 | $57K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 371 | $325K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 523 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.