| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | ANTHEM BLUE CROSS AND BLUE SHIELD | $30K | $5K | $36K | 2.75% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | PO BOX 40925 INDIANAPOLIS, IN 46280 | ANTHEM BLUE CROSS AND BLUE SHIELD | $3K | $0 | $3K | 0.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 444 MARKET ST SUITE 1600 SAN FRANCISCO, CA 94111 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | $182 | $182 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 775 YARD ST SUITE 200 COLUMBUS, OH 43212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $680 | $57 | $737 | 11.86% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $224 | $26 | $250 | 4.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 26 CENTURY BLVD NASHVILLE, TN 37214 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $431 | $152 | $583 | 9.90% |
| PHELAN INSURANCE AGENCY, INC.3 Filed as: PHELAN INSURANCE AGENCY INC. | PO BOX 1 VERSAILLES, OH 45380 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44 | — | $44 | 0.75% |
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 | 101 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS AND BLUE SHIELD | 192 | $1.3M |
| Dental | ANTHEM BLUE CROSS AND BLUE SHIELD | 192 | $1.3M |
| Vision | ANTHEM BLUE CROSS AND BLUE SHIELD | 192 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 192 | $1.3M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 26 | $6K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 27 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.