| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KATHERINE ROSE LANG3 Filed as: KATHERINE R LANG | 21617 HALWORTH RD SHAKER HEIGHTS, OH 44122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 2.91% |
| HUNTINGTON INSURANCE INC3 | 121 NORTH MARKET ST STE 6 WOOSTER, OH 44691 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 2.51% |
| CHARLES HUGH MACKAY3 Filed as: CHARLES H MACKAY | 2383 S MAIN ST AKRON, OH 44319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 1.94% |
| MICHELLE L DAVIS3 | 68 CHELMSFORD DR AURORA, OH 44202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 1.15% |
| TJH CONSULTANTS LLC3 | 2720 BRIARWOOD CT POLAND, OH 44514 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.88% |
| PAUL D QUILLIN3 | 955 WINDHAM CT YOUNGSTOWN, OH 44512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.53% |
| RICHARD J LINDEMEYER3 | 133 MEDINA RD MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $425 | — | $425 | 0.19% |
| A C LONG & ASSOCIATES INC3 Filed as: A.C. LONG & ASSOCIATES INC | 1113 MEDINA RD SUITE 500 MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $400 | — | $400 | 0.18% |
| CARLA J ELENZ3 | 118 HAWKINS LN COLUMBIANA, OH 44408 | CONTINENTAL AMERICAN INSURANCE COMPANY | $282 | — | $282 | 0.13% |
| TERRI L CAMPBELL3 | 1133 MEDINA RD MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $271 | — | $271 | 0.12% |
| PENNY J DAVIS3 | 955 WINDHAM CT BOARDMAN, OH 44512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $94 | — | $94 | 0.04% |
| MICHAEL K MARVILLE3 | 1476 S HIGH STREET COLUMBUS, OH 43207 | CONTINENTAL AMERICAN INSURANCE COMPANY | $70 | — | $70 | 0.03% |
| SHAWN HEITNER3 | 1113 MEDINA ROAD SUITE 500 MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.01% |
| THERESA L GOIK3 | 1816 W NIGHTHAWK WAY PHOENIX, AZ 85045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | — | $23 | 0.01% |
| AMANDA C LONG3 | 1113 MEDINA RD STE 500 MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | — | $19 | 0.01% |
| AMBER M OPPMAN3 | 3725 MEDINA RD MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.01% |
| JOHN D SUSIE3 | 8682 HAWICK CT N DUBLIN, OH 43017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| FRANCES GUDDY3 | 1133 MEDINA RD #200 MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| TERRI PEASE3 Filed as: TERRI L PEASE | 414 OAK STREET WADSWORTH, OH 44281 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| KEVIN LORENZEN3 Filed as: KEVIN A LORENZEN | 109 DIAMOND TAIL ROAD PLACITAS, NM 87043 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| HUNTINGTON INSURANCE INC3 Filed as: HUNTINGTON INSURANCE INC. | 310 GRANT ST PITTSBURGH, PA 15219 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 4.49% |
| HUNTINGTON INSURANCE INC3 | 221 SOUTH CHURCH STREET BOWLING GREEN, OH 43260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 12.50% |
| HUNTINGTON INSURANCE INC3 | 221 SOUTH CHURCH STREET BOWLING GREEN, OH 43260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 12.50% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 87 | $138K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 87 | $138K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 87 | $138K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 230 | $223K |
| Other(4 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 230 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.