| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES A BURRESS3 Filed as: JAMES A. BURRESS | 6418 FAYBOROUGH COURT DUBLIN, OH 43016 | AFLAC | $7K | $111 | $7K | 8.23% |
| MELODY ANN WRENN3 | 145 RED WILLOW ROAD STATE COLLEGE, PA 16801 | AFLAC | $5K | $364 | $6K | 6.19% |
| KIMBERLY NIETO3 Filed as: KIMBERLY NIETO AND OTHER AGENTS | 5419 CLUB DRIVE WESTERVILLE, OH 43082 | AFLAC | $4K | $302 | $5K | 5.06% |
| BERNADETTE PAVLICK3 | 681 NORTH JAMES ROAD COLUMBUS, OH 43219 | AFLAC | $1K | $169 | $2K | 1.81% |
| ADRIENNE HOLBROOK3 Filed as: ADRIENNE A. M. HOLBROOK | 5202 YORK COUNTY ROAD COLUMBUS, OH 43221 | AFLAC | $1K | $2 | $1K | 1.43% |
| ADRIENNE HOLBROOK3 Filed as: ADRIENNE A. M. HOLBROOK | 413 LILYFIELD LANE GALLOWAY, OH 43119 | AFLAC | $1K | $50 | $1K | 1.33% |
| HUNTINGTON INSURANCE INC3 Filed as: HUNTINGTON INSURANCE, INC. | 121 NORTH MARKET STREET, SUITE 600 WOOSTER, OH 44691 | AFLAC | $1K | $0 | $1K | 1.33% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, SUITE 2400 CINCINNATI, OH 45202 | AMERICAN UNITED LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, SUITE 2400 CINCINNATI, OH 45202 | AMERICAN UNITED LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | AMERICAN UNITED LIFE INSURANCE COMPANY | 165 | $34K |
| Short-term disability | AFLAC | 120 | $89K |
| Other(2 contracts) | AMERICAN UNITED LIFE INSURANCE COMPANY | 165 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.