| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADM BENEFIT PLANS AGENCY, INC.3 Filed as: ADM BENEFIT PLANS AGENCY INC. | P.O. BOX 624 BUCYRUS, OH 44820 | MEDICAL MUTUAL | $32K | — | $32K | 3.64% |
| ADM BENEFIT PLANS AGENCY, INC.3 Filed as: ADM BENEFIT PLANS AGENCY INC. | P.O. BOX 624 BUCYRUS, OH 44820 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 4.79% |
| ADM BENEFIT PLANS AGENCY, INC.3 | P.O. BOX 624 BUCYRUS, OH 448200624 | VISION SERVICE PLAN | $935 | — | $935 | 6.15% |
| ADM BENEFIT PLANS AGENCY, INC.3 Filed as: ADM BENEFIT PLANS AGENCY INC. | P.O. BOX 624 BUCYRUS, OH 44820 | ANTHEM LIFE INSURANCE COMPANY | $361 | — | $361 | 10.86% |
| ADM BENEFIT PLANS AGENCY, INC.3 Filed as: ADM BENEFIT PLANS AGENCY INC. | P.O. BOX 6624 BUCYRUS, OH 44820 | AFLAC | $72 | — | $72 | 2.73% |
| DAWN RATLIFF3 | 7610 DONNENWIRTH ROAD NEW WASHINGTON, OH 44854 | AFLAC | $58 | — | $58 | 2.20% |
| GARY J SUEVER3 | P.O. BOX 225 DELPHOS, OH 45833 | AFLAC | $43 | — | $43 | 1.63% |
| WILLIAM HERDER3 Filed as: WILLIAM A HERDER | 3519 BAKERS LANE LUCAS, OH 44843 | AFLAC | $26 | — | $26 | 0.98% |
| HERBERT P SHNIDER3 | 6192 MCNAUGHTEN GROVE LN COLUMBUS, OH 43213 | AFLAC | $22 | — | $22 | 0.83% |
| TINA M THOMPSON DENNIS3 | 1218 WONDERLICK RD. LIMA, OH 45805 | AFLAC | $20 | — | $20 | 0.76% |
| QUINN, MEYER & ASSOCIATES3 | 10800 WINCHCOMBE DR. DUBLIN, OH 43016 | AFLAC | $13 | — | $13 | 0.49% |
| DANIEL L JONES3 | 201 NORTH MAIN STREET DELPHOS, OH 45833 | AFLAC | $12 | — | $12 | 0.45% |
| MICHAEL J QUINN3 | 8580 MAJORCA LANE NAPLES, FL 34114 | AFLAC | $3 | — | $3 | 0.11% |
| MICHAEL E MCCARTHY3 | P.O. BOX 1047 DUNDEE, IL 60118 | AFLAC | $3 | — | $3 | 0.11% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 134 | $881K |
| Dental | HUMANA INSURANCE COMPANY | 137 | $60K |
| Vision | VISION SERVICE PLAN | 134 | $15K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 144 | $3K |
| Prescription drug | MEDICAL MUTUAL | 134 | $881K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 144 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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."
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.