| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | COMMUNITY INSURANCE COMPANY (G1728) | — | — | $0 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | DENTAL CARE PLUS | $4K | — | $4K | 3.21% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $7K | $12K | 13.15% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $5K | $9K | 15.29% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 15.18% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 16.79% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVENUE, STE. 400 DAYTON, OH 45402 | EYEMED VISION CARE | $2K | — | $2K | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY(G1728) EIN 31-1440175 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $196K |
| MCGOHAN BRABENDER AGCY INC | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 409 E MONUMENT AVE STE 400 DAYTON, OH 45402 | $16K |
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 | 272 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY (G1728) | 335 | $189K |
| Dental | DENTAL CARE PLUS | 472 | $137K |
| Vision | EYEMED VISION CARE | 425 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $121K |
| Short-term disability(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $177K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $58K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (G1728) | 335 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 472 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.