| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUDY STAPLETON AND SON3 | 122 N MAIN STREET SWANTON, OH 43558 | AETNA LIFE INSURANCE COMPANY | $104K | — | $104K | 1.35% |
| STAPLETON GROUP, INC.3 | P.O. BOX 1118 SYLVANIA, OH 435605118 | PRINCIPAL LIFE INSURANCE COMPANY | $23K | $5K | $28K | 4.68% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL, INC. | 315 GREEN RIDGE RD. STE. H1 NEW CASTLE, PA 161056145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31K | $8K | $39K | 13.53% |
| STAPLETON INSURANCE & RISK MGMT INC3 | PO BOX 1118 SYLVANIA, OH 435605118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21K | — | $21K | 7.20% |
| LAYNE FINANCIAL INC Filed as: LAYNE FINANCIAL, INC. | 315 GREEN RIDGE RD. STE. H1 NEW CASTLE, PA 161056145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $29K | $8K | $36K | 13.64% |
| STAPLETON INSURANCE & RISK MGMT INC3 | P.O. BOX 1118 SYLVANIA, OH 435605118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | — | $19K | 7.20% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL, INC. | 315 GREEN RIDGE RD. STE. H1 NEW CASTLE, PA 161056145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 13.56% |
| STAPLETON INSURANCE & RISK MGMT INC3 | P.O. BOX 1118 SYLVANIA, OH 435605118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 7.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $469K |
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 | 868 | 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) | 868 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 817 | $7.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 1,474 | $600K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 1,474 | $600K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,474 | $865K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,474 | $885K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,474 | $700K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,474 | — |
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.