| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| C. SHAWN BOGENRIEF3 | UNKNOWN GALION, OH 44833 | DELTA DENTAL OF OHIO | $12K | $0 | $12K | 1.97% |
| SHAWN J KEELER3 Filed as: SHAWN J. KEELER | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $50K | $0 | $50K | 16.99% |
| GARY MOSELEY3 Filed as: GARY L. MOSELY | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18K | $0 | $18K | 6.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 EAST CARMEL DRIVE, SUITE 350 CARMEL, IN 46032 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | $0 | $8K | 2.80% |
| KEELER & ASSOCIATES3 Filed as: KEELER AND ASSOCIATES | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 1.41% |
| SHAWN L MOSELEY3 Filed as: SHAWN L. MOSELEY | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.35% |
| MJ INSURANCE3 Filed as: JACK L. SHORT AND VARIOUS AGENTS | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.35% |
| GAYLE A. DENNIS3 Filed as: GAYLE DENNIS | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $789 | $0 | $789 | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | EYEMED VISION CARE | $15K | $0 | $15K | 9.86% |
| GARY MOSELEY3 Filed as: GARY L. MOSELY | UNKNOWN GALION, OH 44833 | ASSURITY LIFE INSURANCE | $24K | $0 | $24K | 20.98% |
| DOUGLAS GEORGE KEELER3 | UNKNOWN GALION, OH 44833 | ASSURITY LIFE INSURANCE | $4K | $0 | $4K | 3.86% |
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 | 1,038 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,041 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ASSURITY LIFE INSURANCE | 502 | $115K |
| Dental | DELTA DENTAL OF OHIO | 2,386 | $611K |
| Vision | EYEMED VISION CARE | 2,068 | $156K |
| Life insurance | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 749 | $294K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 749 | $294K |
| Long-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 749 | $294K |
| Prescription drug | ASSURITY LIFE INSURANCE | 502 | $115K |
| Other | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 749 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,386 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.