| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | MEDICAL MUTUAL | $85K | $28K | $113K | 4.65% |
| WILLIAM A GRAHAM COMPANY4 Filed as: WILLIAM H HERTZOG | 13700 STATE RD STE 6 NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $1 | $8K | 6.86% |
| PATRICIA HERTZOG4 | 8825 CHAUCER BLVD BROADVIEW HTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $57 | $4K | 3.36% |
| KATHLEEN BYRNE4 | 7142 ANTHONY LN PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| DAVID L SMELCER4 | 3137 TOWNSHIP RD 97 MCCOMB, OH 45858 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GEORGE HORNE | 3410 MAGNOLIA WAY BROADVIEW HTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.02% |
| DEBORAH S GOLDEN4 Filed as: DEBORAH A WILLHITE | 3619 1 2 PONCIANA AVENUE AKRON, OH 44319 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| INSURANCE PARTNERS AGENCY INC4 Filed as: INSURANCE PARTNERS AGENCY LLC | 26865 CENTER RIDGE RD WESTLAKE, OH 44145 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| AMY PARTEE4 | 6665 STONE RD MEDINA, OH 44256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT, ALAN GREENBURG | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $9K | — | $9K | 10.24% |
| WILLIAM A GRAHAM COMPANY4 Filed as: WILLIAM H HERTZOG | 13700 STATE RD STE 6 NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.31% |
| ELIZABETH C ROBERTS4 | PO BOX 2791 HARLINGEN, TX 78551 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $643 | $175 | $818 | 2.41% |
| DION CHAVEZ4 | PO BOX 533070 HARLINGEN, TX 78553 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $354 | $81 | $435 | 1.28% |
| PATRICIA HERTZOG4 | 8825 CHAUCER BLVD BROADVIEW HTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $380 | $6 | $386 | 1.14% |
| SALAZAR INSURANCE GROUP LLC4 | 611 E LOOP 499 HARLINGEN, TX 78550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $74 | $138 | 0.41% |
| JORGE ALEJANDRO MONTEMAYOR4 | 10702 N 23RD LN MCALLEN, TX 78504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| DAVID L SMELCER4 | 3137 TOWNSHIP RD 97 MCCOMB, OH 45858 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROBERT CHAMPION4 | 3115 BRIGHTWOOD AVE EDINBURG, TX 78539 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | SUPERIOR VISION PLAN | $1K | — | $1K | 10.04% |
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 | 291 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 212 | $2.4M |
| Dental | DELTA DENTAL OF OHIO | 291 | $84K |
| Vision | SUPERIOR VISION PLAN | 267 | $14K |
| Prescription drug | MEDICAL MUTUAL | 212 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.