| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DENNIS R. SHIELS & ASSOCIATES INC.3 Filed as: DENNIS R. SHIELS & ASSOCIATES INC | 9200 MONTGOMERY RD BLDG E STE 17B CINCINNATI, OK 45242 | WESTPORT INSURANCE CORPORATION | $55K | $0 | $55K | 7.26% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | WESTPORT INSURANCE CORPORATION | $51K | $0 | $51K | 6.74% |
| BAS3 | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | WESTPORT INSURANCE CORPORATION | $8K | $0 | $8K | 1.00% |
| DENNIS R. SHIELS & ASSOCIATES INC.3 Filed as: DENNIS R SHIELS & ASSOCIATES INC | 9200 MONTGOMERY ROAD BLDG E STE 17B CINCINNATI, OH 45242 | METROPOLITAN LIFE INSURANCE COPMANY | $7K | $1K | $8K | 4.10% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 W. WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | METROPOLITAN LIFE INSURANCE COPMANY | $4K | $0 | $4K | 1.72% |
| DENNIS R. SHIELS & ASSOCIATES INC.3 Filed as: DENNIS R SHIELS & ASSOCIATES | 9200 MONTGOMERY RD CINCINNATI, OH 45242 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $1K | $3K | 4.51% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.47% |
| DENNIS R. SHIELS & ASSOCIATES INC.3 Filed as: DENNIS R SHIELS & ASSOCIATES | 9200 MONTGOMERY RD BLDG E STE 17B CINCINNATI, OH 45242 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 10.98% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.49% |
| CBA BENEFIT SERVICES3 | 73 W. WILSON BRIDGE ROAD SUITE B6 WORTHINGTON, OH 43085 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 9.26% |
| EDWARD D SOMMER3 | 300 W WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BAS RECORD KEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | $121K |
| MEDICAL EXCESS/SHIELS/HCC LIFE RECORD KEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 9200 MONTGOMERY ROAD CINCINNATI, OH 45242 | $53K |
| HEALTHCOMP RECORD KEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 621 SANTA FE AVE FRESNO, CA 93721 | $10K |
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 | 619 | 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) | 619 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTPORT INSURANCE CORPORATION | 432 | $811K |
| Dental | METROPOLITAN LIFE INSURANCE COPMANY | 1,369 | $204K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,354 | $70K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 798 | $58K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 432 | $763K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 798 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,369 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.