| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | GUARDIAN | $39K | $10K | $49K | 10.87% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC | 11740 SW 68TH PARKWAY PORTLAND, OR 97223 | GUARDIAN | $327 | — | $327 | 0.07% |
| RX BENEFITS5 | 3700 COLONNADE PARKWAY BIRMINGHAM, AL 35243 | RX BENEFITS | $0 | $3K | $3K | 0.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $233K |
| MCGOHAN BRABENDER, INC. EIN 31-1191330 BROKER | Other commissions Service code 55 | — | $77K |
| JAMES A. SCOTT EIN 54-0372970 BROKER | Other commissions Service code 55 | — | $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 | 270 | 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) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RX BENEFITS | 240 | $432K |
| Dental | GUARDIAN | 294 | $452K |
| Vision | GUARDIAN | 294 | $452K |
| Life insurance | GUARDIAN | 294 | $452K |
| Short-term disability | GUARDIAN | 294 | $452K |
| Long-term disability | GUARDIAN | 294 | $452K |
| Stop-loss / reinsurancereinsurance(2 contracts) | TOKIO MARINE | 241 | $631K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 294 | $488K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.