| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $9K | $12K | 4.09% |
| MELODY ANN WRENN3 Filed as: MELODY ANN WREN | 145 RED WILLOW RD. STATE COLLEGE, PA 16801 | AFLAC | $8K | $498 | $8K | 9.34% |
| BERNADETTE PAVLICK3 | 681 N JAMES RD. COLUMBUS, OH 43219 | AFLAC | $5K | $266 | $6K | 6.64% |
| HUNTINGTON INSURANCE INC3 Filed as: HUNTINGTON INSURANCE INC. | 121 NORTH MARKET STREET STE. 600 WOOSTER, OH 44691 | AFLAC | $2K | — | $2K | 2.07% |
| JAMES A BURRESS3 Filed as: JAMES A. BURRESS | 6418 FAYBOROUGH CT. DUBLIN, OH 43016 | AFLAC | $2K | $152 | $2K | 2.04% |
| SHAWN M THEIS3 Filed as: SHAWN M. THEIS | 3309 WESTERVILLE WOODS DR. COLUMBUS, OH 43231 | AFLAC | $715 | — | $715 | 0.83% |
| HARE AND ASSOCIATES LLC3 | 470 OLDE WORTHINGTON RD. STE. 250 WESTERVILLE, OH 43082 | AFLAC | $542 | $152 | $694 | 0.80% |
| HARE AND ASSOCIATES LLC3 | 470 OLDE WORTHINGTON RD. STE. 250 WESTERVILLE, OH 43082 | AFLAC | $666 | — | $666 | 0.77% |
| PAULA GAIL NEAL3 Filed as: PAULA C. CUTTER | 1795 ALYSHEBA WAY STE. 1204 LEXINGTON, KY 40509 | AFLAC | $658 | — | $658 | 0.76% |
| KIMBERLY NIETO3 | 5419 CLUB DRIVE WESTERVILLE, OH 43082 | AFLAC | $477 | — | $477 | 0.55% |
| ROBERT P HARE3 Filed as: ROBERT P. HARE | 470 OLDE WORTHINGTON RD. STE. 250 WESTERVILLE, OH 43082 | AFLAC | $268 | — | $268 | 0.31% |
| SCOTT A SMITH3 Filed as: SCOTT A. SMITH | 5300 OAKBROOK PKWY BLDG. 300 STE. 350 NORCROSS, GA 30093 | AFLAC | $152 | — | $152 | 0.18% |
| DANIEL J LONG3 Filed as: DANIEL J. LONG | 48 EISENTOWN DR LOVETTSVILLE, VA 20180 | AFLAC | $82 | — | $82 | 0.10% |
| JOHN E HRIVNAK3 Filed as: JOHN E. HRIVNAK | 3900 INDUSTRIAL PARK DR., STE. 11 ALTOONA, PA 16602 | AFLAC | $58 | — | $58 | 0.07% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE STE. 300 BRIDGEVILLE, PA 15017 | AFLAC | $49 | — | $49 | 0.06% |
| ALBERT WAITMAN JR3 Filed as: ALBERT WAITMAN JR. | 503 CAMP ST. SANDUSKY, OH 44870 | AFLAC | $28 | — | $28 | 0.03% |
| KRISTOFER RUBLE3 Filed as: KRISTOFER P. RUBLE | 3117 EAST BAYVIEW LN SANDUSKY, OH 44870 | AFLAC | $18 | — | $18 | 0.02% |
| MARCUS WAYNE MCREE3 | 1162 E BROAD ST., APT E1 COLUMBUS, OH 43205 | AFLAC | $12 | — | $12 | 0.01% |
| WILLIAM J BALL III3 Filed as: WILLIAM J. BALL, III | 9 STOUTENBURG DR. NORWALK, OH 44857 | AFLAC | $11 | — | $11 | 0.01% |
| JANE ELLEN HILL3 | PO BOX 2341 LANCASTER, OH 43130 | AFLAC | $6 | — | $6 | 0.01% |
| TIM WEISENBACH3 Filed as: TIM D. WEISENBACH | 7915 S. EMERSON ST., STE. 130 INDIANAPOLIS, IN 46237 | AMERICAN UNITED LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE DENTAL CARE PLUS GROUP | $2K | — | $2K | 8.90% |
| TIMOTHY D. WEISENBACH3 | 4530 PEPPER CT. INDIANAPOLIS, IN 46237 | THE DENTAL CARE PLUS GROUP | $472 | — | $472 | 2.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNION SECURITY INSURANCE COMPANY | $82 | — | $82 | 4.97% |
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 | 241 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 141 | $285K |
| Dental | THE DENTAL CARE PLUS GROUP | 139 | $18K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 241 | $23K |
| Short-term disability | AFLAC | 85 | $86K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 241 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.