| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF THE MIDWES | 601 CLINTON ST DEFIANCE, OH 43512 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $122K | $24K | $146K | 13.96% |
| TINA M DENNIS3 | 1218 WONDERLICK ROAD LIMA, OH 45805 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53K | — | $53K | 16.35% |
| AARON ANSPACH LLC3 | 21397 LEHMAN ROAD DELPHOS, OH 45833 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15K | — | $15K | 4.55% |
| TARA D CASCIOLI3 | 505 N WESTMINSTER ST WAYNESFIELD, OH 45896 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 1.19% |
| CHAD A POLLOCK3 | 1106 LINDEN DRIVE VAN WERT, OH 45891 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.47% |
| JAMES LOCKWOOD3 | 134 W SOUTH BOUNDARY ST STE A PERRYSBURG, OH 43551 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.35% |
| ANTHONY JOSEPH MOTTER3 Filed as: ANTHONY J MOTTER | 2268 MCKINLEY DRIVE PERRYSBURG, OH 43551 | CONTINENTAL AMERICAN INSURANCE COMPANY | $595 | — | $595 | 0.18% |
| OLIVIA R THOMPSON3 | 1218 WONDERLICK ROAD LIMA, OH 45805 | CONTINENTAL AMERICAN INSURANCE COMPANY | $274 | — | $274 | 0.08% |
| GARY E SADLER3 | 4244 SCHOOLER RD CRIDERSVILLE, OH 45806 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.01% |
| KRISTEN D PRESTON3 | 6745 COUNTY ROAD 45 ALGER, OH 45812 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MICHAEL C HURLEY3 Filed as: MICHAEL HURLEY | 7484 ST RT 195 ALGER, OH 45812 | AFLAC | $1K | — | $1K | 3.46% |
| DANA HOBBS3 | 1221 WOOD HOLLOW DR APT 13104 HOUSTON, TX 77057 | AFLAC | $405 | — | $405 | 1.19% |
| NICK RYAN HURLEY3 | 0329 COUNTY RD 80 ALGER, OH 45812 | AFLAC | $340 | — | $340 | 1.00% |
| MARC WRIGHT BENEFITS CONSULTING LLC3 | 3029 CANTERBURY DR LIMA, OH 45805 | AFLAC | $288 | — | $288 | 0.85% |
| CHAD L NELSON3 Filed as: CHAD POLLOCK | 6506 ANTHONY DR MAUMEE, OH 43537 | AFLAC | $255 | — | $255 | 0.75% |
| AARON ANSPACH LLC3 | 209 N MAIN ST STE 6 LIMA, OH 45801 | AFLAC | $212 | — | $212 | 0.62% |
| SAIC INC3 | 4245 MILGEN RD COLUMBUS, GA 31907 | AFLAC | $165 | — | $165 | 0.49% |
| TINA M THOMPSON DENNIS3 Filed as: TINA THOMPSON DENNIS | 1218 WONDERLICK RD LIMA, OH 45805 | AFLAC | $124 | — | $124 | 0.37% |
| DANIEL L JONES3 | 201 N MAIN ST DELPHOS, OH 45833 | AFLAC | $114 | — | $114 | 0.34% |
| BRIAN J DAY3 | 13189 HITCHING POST RD DEWITT, MI 48820 | AFLAC | $111 | — | $111 | 0.33% |
| R AND L SUPPLEMENTAL BENEFITS INC3 Filed as: R & L SUPPLEMENTAL BENEFITS INC | PO BOX 893 FLORENCE, AL 35631 | AFLAC | $98 | — | $98 | 0.29% |
| APRIL P KILLGORE3 | 324 STONEHAM WAY MADISON, AL 35756 | AFLAC | $90 | — | $90 | 0.26% |
| MELISSA S SHNIDER3 | 3000 WOLF CREEK WAY BURLINGTON, KY 41005 | AFLAC | $71 | — | $71 | 0.21% |
| SUE A JONES3 | PO BOX 264 DELPHOS, OH 45833 | AFLAC | $61 | — | $61 | 0.18% |
| JOHN K CASEY3 | 143 WINDING CREEK RD NW MADISON, AL 35757 | AFLAC | $54 | — | $54 | 0.16% |
| MELISSA A BRINKER3 | 11260 CHESTER RD STE 100 CINCINNATI, OH 45246 | AFLAC | $38 | — | $38 | 0.11% |
| MICKLEY CONSULTING LLC3 | 400 W WILSON BRIDGE RD STE 200 WORTHINGTON, OH 43085 | AFLAC | $29 | — | $29 | 0.09% |
| IAN B BRANYON3 | 2301 LUCIEN WAY STE 150 MAITLAND, FL 32751 | AFLAC | $28 | — | $28 | 0.08% |
| QUINN, MEYER & ASSOCIATES3 Filed as: QUINN MEYER & ASSOCIATES | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $22 | — | $22 | 0.06% |
| LOUIS CULLEN SMITH3 | 3205 QUIET TREE GRV OLD HICKORY, TN 37138 | AFLAC | $21 | — | $21 | 0.06% |
| JAMES J GRETHEL3 | 865 CEDAR DR LOVELAND, OH 45140 | AFLAC | $19 | — | $19 | 0.06% |
| SHAWN M MCDERMOTT3 | 9543 CONKLIN AVE CINCINNATI, OH 45242 | AFLAC | $14 | — | $14 | 0.04% |
| KENNETH MCGUIRE3 | 171 CARLOS LN LIMA, OH 45804 | AFLAC | $13 | — | $13 | 0.04% |
| MICHAEL E MCCARTHY3 Filed as: MICHAEL MCCARTHY | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $13 | — | $13 | 0.04% |
| ALAN G NASH3 | 1 OWL LN FLORENCE, AL 35630 | AFLAC | $13 | — | $13 | 0.04% |
| WILLIAM M HURLEY3 Filed as: WILLIAM H ROBERTS | 3749 SACHEM AVE CINCINNATI, OH 45226 | AFLAC | $12 | — | $12 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL QUINN | 8580 MAJORCA LN NAPLES, FL 34114 | AFLAC | $12 | — | $12 | 0.04% |
| ANTHONY JOSEPH MOTTER3 Filed as: ANTHONY J MOTTER | 134 W SOUTH BOUNDARY ST STE A PERRYSBURG, OH 43551 | AFLAC | $11 | — | $11 | 0.03% |
| CHRISTOPHER D BOULDREY3 | PO BOX 602 CONCORD, MI 49237 | AFLAC | $10 | — | $10 | 0.03% |
| INGER M PENNINGTON3 Filed as: INGER PENNINGTON | 7179 HONEYWOOD CT CINCINNATI, OH 45230 | AFLAC | $9 | — | $9 | 0.03% |
| RONALD BLACKORBY3 | 109 HOLLOW AVE JERSEYVILLE, IL 62052 | AFLAC | $9 | — | $9 | 0.03% |
| ROBERT P HARE3 Filed as: ROBERT HARE | 6324 TARTON FIELDS LN MASON, OH 45040 | AFLAC | $8 | — | $8 | 0.02% |
| RONALD J GRETHEL3 | 648 HANNA AVE LOVELAND, OH 45140 | AFLAC | $7 | — | $7 | 0.02% |
| JOHN TODD LEE3 Filed as: JOHN T LEE | 322 FARMHOUSE RD ELLERSLIE, GA 31807 | AFLAC | $6 | — | $6 | 0.02% |
| BRIAN HICKS3 | 188 FRONT ST STE 11639 FRANKLIN, TN 37064 | AFLAC | $4 | — | $4 | 0.01% |
| OLIVIA R THOMPSON3 Filed as: OLIVIA THOMPSON | 1218 WONDERLICK RD LIMA, OH 45805 | AFLAC | $3 | — | $3 | 0.01% |
| JOHN C RASCHELLA3 Filed as: JOHN RASCHELLA | 20521 TAHITIAN BLVD ESTERO, FL 33928 | AFLAC | $3 | — | $3 | 0.01% |
| STAN A SHERLIN3 Filed as: STAN SHERLIN | 773 TOWNE LAKE DR MONTGOMERY, AL 36117 | AFLAC | $3 | — | $3 | 0.01% |
| KANDACE M MCCARTHY3 Filed as: KANDACE MCCARTHY | PO BOX 1047 304 CANTERFIELD PKWY WEST DUNDEE, IL 60118 | AFLAC | $2 | — | $2 | 0.01% |
| JOSEPH P CALARCO3 Filed as: JOSEPH EVANS | 764 80TH ST WEST DES MOINES, IA 50266 | AFLAC | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 THIRD PARTY ADMINISTRATOR | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Contract Administrator; Float revenue Service code 12 | — | $1.2M |
| INGENIO RX, INC. EIN 82-3062245 PRESCRIPTION DRUG REBATES | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $488K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 PRESCRIPTION DRUG REBATES | Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $0 |
| FIRST INSURANCE GROUP OF THE MIDWES EIN 34-0940616 SERVICE PROVIDER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $0 |
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 | 812 | 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) | 812 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,002 | $1.0M |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,002 | $1.0M |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,002 | $1.0M |
| Short-term disability(3 contracts, 3 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,002 | $1.4M |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,002 | $1.0M |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (G1728) | 812 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,002 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.