| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PHELAN INSURANCE AGENCY, INC.3 Filed as: PHELAN INSURANCE AGENCY INC. | PO BOX 1 VERSAILLES, OH 45380 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $23K | $23K | 3.09% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INS SERV AGNCY | 2101 FLORENCE AVE. CINCINNATI, OH 45206 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 0.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: HRH - WILLIS OF OHIO, INC. | 775 YARD STREET-SUITE 200 COLUMBUS, OH 43212 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $5K | $5K | 0.64% |
| PHELAN INSURANCE AGENCY, INC.3 | 863 MAIN STREET - BOX 1 VERSAILLES, OH 45380 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | — | $1K | 9.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO - COLUMBUS | 131 S. DEARBORN - 6TH FLOOR CHICAGO, IL 60603 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $266 | — | $266 | 2.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD STREET, SUITE 200 COLUMBUS, OH 43212 | UNITEDHEALTHCARE INSURANCE COMPANY | $495 | — | $495 | 6.09% |
| PHELAN INSURANCE AGENCY, INC.3 Filed as: PHELAN INSURANCE AGENCY INC. | PO BOX 1 VERSAILLES, OH 45380 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $682 | — | $682 | 13.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC. | PO BOX 93234 CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $119 | $10 | $129 | 2.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | PO BOX 93234 CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $241 | $20 | $261 | 6.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | PO BOX 93234 CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $134 | $14 | $148 | 6.30% |
No Schedule C service providers reported on this filing.
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 218 | $732K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 218 | $732K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 232 | $13K |
| Life insurance(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 134 | $13K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 38 | $8K |
| Other(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 134 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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.