| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN CLARK3 Filed as: STEVEN P CLARK | P.O. BOX 52 TALLMADGE, OH 44278 | HEALTHKEEPERS, INC. | $15K | — | $15K | 2.31% |
| STEVEN CLARK3 | P.O. BOX 52 TALLMADGE, OH 442780052 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.20% |
| STEVEN CLARK3 Filed as: STEVEN P CLARK | OHIO HEALTH BENEFITS P.O. BOX 52 TALLMADGE, OH 44278 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.23% |
| JAMES JACOBS, CHFC, CLU3 | 11313 LAUREL COVE LANE CHESTERFIELD, VA 23838 | MONY LIFE INSURANCE COMPANY OF AMERICA | $540 | — | $540 | 6.09% |
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 | 134 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHKEEPERS, INC. | 333 | $633K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 308 | $67K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 133 | $9K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 116 | $18K |
| Other | MONY LIFE INSURANCE COMPANY OF AMERICA | 133 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.