| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.5 | PO BOX 30541 SALT LAKE CITY, UT 841300541 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $106K | $106K | 29.11% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD, SUITE 540 INDEPENDENCE, OH 44131 | RELIASTAR LIFE INSURANCE COMPANY | $26K | $0 | $26K | 7.21% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS MCKIBBEN BONGIOVANNI & CO. | 100 STATE ST, SUITE 300 ERIE, PA 16507 | UPMC HEALTH OPTIONS | $10K | $0 | $10K | 3.57% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 4700 ROCKSIDE RD, SUITE 540 CLEVELAND, OH 44131 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $303 | $8K | 21.32% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 4700 ROCKSIDE RD, SUITE 540 CLEVELAND, OH 44131 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $235 | $7K | 19.43% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 4700 ROCKSIDE RD, SUITE 540 CLEVELAND, OH 44131 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $332 | $2K | 14.56% |
| PLANCORP INC3 | 9050 SWEET VALLEY DR VALLEY VIEW, OH 44125 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $479 | $0 | $479 | 3.11% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 | 100 STATE ST, SUITE 300 ERIE, PA 16507 | HIGHMARK HEALTH | $195 | $0 | $195 | 4.03% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS MCKIBBEN BONGIOVANNI & CO. | 100 STATE ST, SUITE 300 ERIE, PA 16507 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $168 | $0 | $168 | 10.80% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS MCKIBBEN BONGIOVANNI & CO. | 100 STATE ST, SUITE 300 ERIE, PA 16507 | UPMC HEALTH OPTIONS | $81 | $0 | $81 | 5.41% |
| THOMAS S FARRO3 Filed as: THOMAS R DETTLING | 3291 STANLEY ROAD AKRON, OH 44333 | HARTFORD LIFE & ACCIDENT COMPANY | $22 | $0 | $22 | 14.86% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UPMC HEALTH OPTIONS | 101 | $289K |
| Vision | HIGHMARK HEALTH | 50 | $5K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $90K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 120 | $15K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $33K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 148 | $364K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.