| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $2K | $12K | 3.10% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE ATTN ACCOUNTING DEPT TOLEDO, OH 43604 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 2.14% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE ATTN ACCOUNTING TOLEDO, OH 43604 | PRINCIPAL LIFE INSURANCE COMPANY | $18K | — | $18K | 6.10% |
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 | 302 | 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) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 295 | $1.9M |
| Dental(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $669K |
| Vision(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $669K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $669K |
| Short-term disability(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $669K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 295 | $1.9M |
| Other(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $669K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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.