| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF THE MIDWES | 511 5TH STREET DEFIANCE, OH 43512 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $109K | $21K | $130K | 12.75% |
| TINA M DENNIS3 | 1218 WONDERLICK RD LIMA, OH 45805 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $42K | $42K | 32.62% |
| OLIVIA R THOMPSON3 | 1218 WONDERLICK RD LIMA, OH 45805 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $10K | $10K | 7.61% |
| AARON ANSPACH LLC3 Filed as: AARON ANSPACH | 21397 LEHMAN ROAD DELPHOS, OH 45833 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $9K | $9K | 7.34% |
| CHAD L NELSON3 Filed as: CHAD POLLOCK | 1106 LINDEN DRIVE VAN WERT, OH 45891 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $6K | $6K | 4.70% |
| GARY E SADLER3 | 4244 SCHOOLER RD CRIDERSVILLE, OH 45806 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $470 | $470 | 0.37% |
| KRISTEN D PRESTON3 | 6745 COUNTY ROAD 45 ALGER, OH 45812 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $313 | $313 | 0.25% |
| MICHAEL C HURLEY3 Filed as: MICHAEL HURLEY | 7484 STATE ROUTE 195 ALGER, OH 45812 | AFLAC | $9K | — | $9K | 9.17% |
| NICK RYAN HURLEY3 | 0329 COUNTY ROAD 80 ALGER, OH 45812 | AFLAC | $1K | — | $1K | 1.34% |
| MARC WRIGHT BENEFITS CONSULTING LLC3 | 131 W NORTH STREET LIMA, OH 45801 | AFLAC | $900 | — | $900 | 0.93% |
| CHAD L NELSON3 Filed as: CHAD POLLOCK | 134 W SOUTH BOUNDARY ST STE A PERRYSBURG, OH 43551 | AFLAC | $862 | $23 | $885 | 0.91% |
| DANA HOBBS3 | 1221 WOOD HOLLOW DR APT 13104 HOUSTON, TX 77057 | AFLAC | $622 | — | $622 | 0.64% |
| DANIEL L JONES3 | 201 N MAIN STREET DELPHOS, OH 45833 | AFLAC | $396 | — | $396 | 0.41% |
| SUE A JONES3 | PO BOX 264 DELPHOS, OH 45833 | AFLAC | $360 | — | $360 | 0.37% |
| TINA M THOMPSON DENNIS3 | 1218 WONDERLICK RD LIMA, OH 45805 | AFLAC | $275 | $70 | $345 | 0.36% |
| BRIAN J DAY3 | 8744 UNION CENTRE BLVD STE 500 WEST CHESTER, OH 45069 | AFLAC | $285 | $36 | $321 | 0.33% |
| SAIC INC3 | 4245 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $224 | — | $224 | 0.23% |
| OLIVIA R THOMPSON3 Filed as: OLIVIA THOMPSON | 1218 WONDERLICK RD LIMA, OH 45805 | AFLAC | $150 | $37 | $187 | 0.19% |
| MELISSA S SHNIDER3 Filed as: MELISSA SUE SHNIDER | 3000 WOLF CREEK WAY BURLINGTON, KY 41005 | AFLAC | $145 | $41 | $186 | 0.19% |
| R AND L SUPPLEMENTAL BENEFITS INC3 Filed as: R&L SUPPLEMENTAL BENEFITS INC | PO BOX 893 FLORENCE, AL 35631 | AFLAC | $161 | — | $161 | 0.17% |
| APRIL P KILLGORE3 | 417 THOREAU SPRING RD MADISON, AL 35758 | AFLAC | $121 | — | $121 | 0.12% |
| LINDA SUE WRIGHT3 | PO BOX 129 BOAZ, AL 35957 | AFLAC | $116 | — | $116 | 0.12% |
| JOHN K CASEY3 | PO BOX 174 MADISON, AL 35758 | AFLAC | $105 | — | $105 | 0.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 SERVICE PROVIDER | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Contract Administrator; Other services Service code 12 | — | $465K |
| COMMUNITY INSURANCE COMPANY 31-1440 | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $189K |
| FIRST INSURANCE GROUP OF THE MIDWES EIN 31-1440175 SERVICE PROVIDER | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $106K |
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 | 644 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE CO, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 644 | $807K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 784 | $1.0M |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 784 | $1.0M |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 784 | $1.0M |
| Short-term disability(3 contracts, 3 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 784 | $1.2M |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 784 | $1.0M |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE CO, DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 644 | $807K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 784 | — |
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.