| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 1001 LAKESIDE AVENUE E, SUITE 1500 CLEVELAND, OH 44114 | UNITEDHEALTHCARE INSURANCE COMPANY | $35K | $0 | $35K | 2.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $724 | $14K | 15.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $0 | $4K | 4.95% |
| DAVID CAMPANA INSURANCE LTD3 Filed as: DAVID CAMPANA INS LTD | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.81% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BENEFITS | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $639 | $0 | $639 | 3.47% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $389 | $0 | $389 | 2.11% |
| COVEY RUN INSURANCE LLC3 Filed as: COVEY RUN INS LLC | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $110 | $0 | $110 | 0.60% |
| LAYNE FINANCIAL INC3 | 3009 WILMINGTON ROAD, SUITE 100 NEW CASTLE, PA 16105 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $100 | $0 | $100 | 0.54% |
| MARK L HUFHAND3 Filed as: MARK L. HUFHAND | 925 SOUTH MAIN STREET NORTH CANTON, OH 44720 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $66 | $0 | $66 | 0.36% |
| MJ INSURANCE3 Filed as: THOMAS BOSTON AND VARIOUS AGENTS | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $40 | $5 | $45 | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | EYEMED ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | $662 | $0 | $662 | 7.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $452 | $0 | $452 | 9.30% |
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 | 118 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 198 | $1.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 90 | $73K |
| Vision(2 contracts, 2 carriers) | EYEMED ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | 154 | $13K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $85K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $85K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 198 | $1.3M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.