| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONNA L BEYLAND3 Filed as: DONNA L. BEYLAND | 519 WINDSOR PARK DRIVE DAYTON, OH 45459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24K | $79 | $24K | 4.87% |
| BRUCE JAY BAKER3 | 2734 CHANCELLOR DRIVE CRESTVIEW HILLS, KY 41017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | — | $14K | 2.88% |
| PATRICIA G SPIES3 Filed as: PATRICIA G. SPIES | 600 SOUTH MARSHALL ROAD MIDDLETOWN, OH 45044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $288 | $12K | 2.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $898 | $12K | 2.40% |
| BEYLAND CONSULTANTS INC3 Filed as: BEYLAND CONSULTANTS, INC. | 519 WINDSOR PARK DRIVE DAYTON, OH 45459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $99 | $7K | 1.36% |
| BRENDA K COX3 Filed as: BRENDA K. COX | 3604 N GRAND AVENUE CONNERSVILLE, IN 47331 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $11 | $5K | 1.04% |
| ROEDING GROUP COMPANIES3 | PO BOX 17900 CRESTVIEW HILLS, KY 41017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.61% |
| BRYAN RICHARD BEYLAND3 | 8811 YANKEE COVE COURT CENTERVILLE, OH 45458 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $723 | — | $723 | 0.15% |
| JOSEPH MCDONALD3 | 12052 PEPPERMILL LANE NW PICKERINGTON, OH 43147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $497 | — | $497 | 0.10% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $281 | $331 | 0.07% |
| HARRIET M. ARGUE3 | 800 BANBURY ROAD DAYTON, OH 45459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $176 | — | $176 | 0.04% |
| JUSTIN J MCDONALD3 Filed as: JUSTIN MCDONALD | 12052 PEPPERMILL LANE PICKERINGTON, OH 43147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.02% |
| KAY JILL, INC.3 | 32303 ACACIA COURT AVON LAKE, OH 44012 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.00% |
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO3 | 8490 MALLARD COURT PLAIN CITY, OH 43064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.00% |
| STEVEN M MAMICK3 Filed as: STEVEN M. MAMICK | 1127 FIRESIDE TRAIL BROADVIEW HTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICE | PO BOX 62889 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 10.07% |
| BEYLAND CONSULTANTS INC3 Filed as: BEYLAND CONSULTANTS, INC. | 519 WINDSOR PARK DRIVE DAYTON, OH 45459 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $37 | — | $37 | 0.07% |
| BRUCE JAY BAKER3 | PO BOX 17900 CRESTVIEW HILLS, KY 41017 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $21 | — | $21 | 0.04% |
| RICHARD BEYLAND3 | 7961 WASHINGTON WOODS DRIVE CENTERVILLE, OH 45459 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.33% |
| BRUCE JAY BAKER3 | 2734 CHANCELLOR DRIVE SUITE 301 CRESTVIEW HILLS, KY 41017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $63 | $1K | 4.56% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INSURANCE | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $65 | $65 | 0.22% |
| BRUCE JAY BAKER3 | 2734 CHANCELLOR DRIVE, SUITE 301 CRESTVIEW HILLS, KY 410173443 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 9.68% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $781 | $49 | $830 | 4.34% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INSURANCE | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $55 | $55 | 0.29% |
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 | 840 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 846 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 793 | $54K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 536 | $526K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 536 | $497K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $19K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 536 | $526K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 793 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.