| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | RELIASTAR LIFE INSURANCE COMPANY | $38K | — | $38K | 8.83% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | HCC LIFE INSURANCE COMPANY | $30K | $5K | $36K | 11.80% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVENUE SE GRAND RAPIDS, MI 49507 | HCC LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS PROCESSOR | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $519K |
| EXPRESS SCRIPTS EIN 31-1714795 PBM | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Other fees; Contract Administrator Service code 12 | — | $12K |
| MCGOHAN BRABENDER, INC. EIN 31-1191330 BROKER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $0 |
| INGENIORX EIN 82-3062245 PBM | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other fees; Claims processing Service code 12 | — | -$47K |
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 | 611 | 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) | 611 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL CARE PLUS | 1,100 | $280K |
| Vision | EYEMED | 916 | $63K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 611 | $428K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 611 | $428K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 482 | $302K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 611 | $428K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,100 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.