| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 1001 LAKESIDE AVE E STE 1600 CLEVELAND, OH 44114 | UNITED HEALTHCARE INSURANCE COMPANY | — | $38K | $38K | 1.25% |
| DAVID L. HERBRUCK3 Filed as: DAVID SABO | 1001 LAKESIDE AVE SUITE 1600 CLEVELAND, OH 44114 | PRIORITY HEALTH | $36K | — | $36K | 1.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Contract Administrator; Claims processing Service code 12 | — | $24K |
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 | 460 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 713 | $5.6M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 669 | $478K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 713 | $3.0M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 669 | $291K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 669 | $291K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 669 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 713 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.