| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 9.63% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | — | $31K | 51.63% |
| DWIGHT L PIERCE5 Filed as: DWIGHT PIERCE BENEFITS TECHNOLOGIES | DIV 10 1200 E TAFT AVE SAPULPA, OK 74066 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $45 | — | $45 | 0.08% |
| CORPORATE ONE BENEFITS3 Filed as: CORPORATE ONE BENEFITS AGENCY INC | PO BOX 906 FOSTORIA, OH 44830 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15 | — | $15 | 0.03% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 18.24% |
| COB INC3 | PO BOX 15023 PIKESVILLE, MD 21282 | TRANSAMERICA LIFE INSURANCE COMPANY | $57 | — | $57 | 6.64% |
| ERIC YEAGER5 | 14337 JEFFRIES PLACE MIDLOTHIAN, VA 23114 | TRANSAMERICA LIFE INSURANCE COMPANY | $40 | — | $40 | 4.66% |
| AFFINITY GROUP UNDERWRITERS3 Filed as: AFFINITY GROUP UNDERWRITERS INC | 4510 COX RD STE 111 GLEN ALLEN, VA 23060 | TRANSAMERICA LIFE INSURANCE COMPANY | $20 | — | $20 | 2.33% |
| COB INC3 | PO BOX 15023 PIKESVILLE, MD 212825023 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $104 | — | $104 | 12.70% |
| ROBERT D SACKS EMPLOYEE SECURITY5 | 10400 LITTLE PATUXENT PKWY STE 260 COLUMBIA, MD 21044 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $35 | $35 | 4.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CUSTOM DESIGN BENEFITS EIN 81-0798821 CONTRACT | Claims processing Service code 12 | 5589 CHEVIOT RD CINCINNATI, OH 45247 | $119K |
| GLOBAL CARE(ZELIS EIN 31-1407689 CONTRACT | Other fees Service code 99 | 6875 SHILOH ROAD EAST ALPHARETTA, GA 30005 | $26K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 ADMINISTRATIVE AGREEMENT | Participant communication; Named fiduciary; Direct payment from the plan; Other services; Non-monetary compensation; Float revenue; Claims processing; Contract Administrator Service code 12 | PO BOX 644546 PITTSBURGH, PA 152644546 | $17K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 CONTRACT | Other fees Service code 99 | 2060 EAST NINTH STREET CLEVELAND, OH 44115 | $8K |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 356 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 325 | $40K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $146K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 246 | $61K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $90K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE COMPANY | 353 | $246K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.