| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFITS SERVICES AGENCY3 | PO BOX 868 DELAWARE, OH 43015 | MEDICAL MUTUAL | $45K | $5 | $45K | 2.54% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SERVICE AGENCY | PO BOX 868 DELAWARE, OH 43015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | $2K | $22K | 16.74% |
| PREFERRED BENEFITS SERVICES AGENCY3 | PO BOX 868 DELAWARE, OH 43015 | DELTA DENTAL OF OHIO | $7K | — | $7K | 10.00% |
| PREFERRED BENEFITS SERVICES AGENCY3 | PO BOX 868 DELAWARE, OH 43015 | VISION SERVICE PLAN | $990 | — | $990 | 5.91% |
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 | 262 | 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) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 134 | $1.8M |
| Dental | DELTA DENTAL OF OHIO | 228 | $73K |
| Vision | VISION SERVICE PLAN | 110 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $128K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $128K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $128K |
| Prescription drug | MEDICAL MUTUAL | 134 | $1.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.