| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIFTH THIRD INSURANCE AGENCY INC3 Filed as: FIFTH THIRD INS AGENCY | 9700 ORMSBY STATION ROAD, SUITE 200 CINCINNATI, OH 45227 | AMERICAN UNITED LIFE INSURANCE COMPANY | $33K | $8K | $41K | 14.59% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PTNRS | 1540 CORNERSTONE BLVD DAYTONA BEACH, FL 32117 | AMERICAN UNITED LIFE INSURANCE COMPANY | $13K | $0 | $13K | 4.67% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PTNRS | SUITE 230 1540 CORNERSTONE BLVD DAYTONA BEACH, FL 321177144 | HUMANA DENTAL INSURANCE COMPANY | $13K | $0 | $13K | 9.63% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 9700 ORMSBY STATION RDZA LOUISVILLE, KY 402234038 | HUMANA DENTAL INSURANCE COMPANY | $4K | $0 | $4K | 2.58% |
| FOUNDATION RISK PARTNERS CORP Filed as: FOUNDATION RISK PTNRS | SUITE 230 1540 CORNERSTONE BLVD DAYTONA BEACH, FL 321177144 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 9.57% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 9700 ORMSBY STATION RDZA LOUISVILLE, KY 402234038 | HUMANA INSURANCE COMPANY | $704 | $0 | $704 | 2.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 AGENT | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | 3075 VANCERCAR WAY CINCINNATI, OH 45209 | $180K |
| FIFTH THIRD INSURANCE AGENCY INC EIN 35-0781558 AGENT | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | MAIL DROP 1MOBBC CINCINNAI, OH 45227 | $0 |
| FOUNDATION RISK PARTNERS CORP EIN 35-0781558 AGENT | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 1540 CORNERSTONE BLVD DAYTONA BEACH, FL 32117 | $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 | 486 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 419 | $510K |
| Dental | HUMANA DENTAL INSURANCE COMPANY | 165 | $137K |
| Vision | HUMANA INSURANCE COMPANY | 267 | $27K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 486 | $282K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 486 | $282K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 486 | $282K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 419 | $510K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 486 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.