| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM H. MEYER AGENCY, INC.3 | 1660 NW PROFESSIONAL PLAZA, STE. J COLUMBUS, OH 43220 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | — | $31K | 2.61% |
| WILLIAM H. MEYER AGENCY, INC.3 Filed as: WILLIAM MEYER | 1660 NW PROFESSIONAL PLAZA, STE. J COLUMBUS, OH 43220 | SUPERIOR DENTAL CARE, INC. | $24K | — | $24K | 3.69% |
| WILLIAM H. MEYER AGENCY, INC.3 | 1660 NW PROFESSIONAL PLAZA, SUITE J COLUMBUS, OH 432203854 | VISION SERVICE PLAN | $6K | — | $6K | 1.36% |
| WILLIAM H. MEYER AGENCY, INC.3 | 1660 NW PROFESSIONAL PLAZA COLUMBUS, OH 43220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 2.93% |
| JAMES D THOMAS3 Filed as: JAMES D. THOMAS | 5451 ST. ANDREWS DR. WESTERVILLE, OH 43082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $658 | $6K | 2.56% |
| HEALTHCARE REFORM ALTERNATIVES LLC3 | 2706 BAR HARBOUR CT. LEWIS CENTER, OH 43035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 2.06% |
| DWAINE K HOWELL3 Filed as: DWAINE K. HOWELL | 79 LAKEVIEW DRIVE THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.74% |
| TONI PAULLUS3 | 1345 NORTHPORT DRIVE COLUMBUS, OH 43235 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.60% |
| ROBERT CLINTON HEARNS3 | 3821 BILL OF RIGHTS SQ. COLUMBUS, OH 43207 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $747 | $47 | $794 | 0.33% |
| EMB UNLIMITED AGENCY INC3 Filed as: EMB UNLIMITED AGENCY, INC. | 7486 EAST MAIN STREET REYNOLDSBURG, OH 43068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $765 | — | $765 | 0.31% |
| MICHAEL W BOYER3 Filed as: MICHAEL W. BOYER | 7587 HONDA HILLS RD. THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $575 | — | $575 | 0.24% |
| NICK WISDA3 | 2196 TOWNSHIP RD. 55 NEVADA, OH 44849 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $496 | $75 | $571 | 0.23% |
| KEVIN D HOWELL3 Filed as: KEVIN D. HOWELL | 60 WEST COLUMBUS STREET THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 0.06% |
| JOSEPH MCDONALD3 | 12052 PEPPERMILL LANE NW PICKERINGTON, OH 43147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.02% |
| PAUL S TERRELL3 Filed as: PAUL S. TERRELL | 610 WHIPPOORWILL DR. CANYON LAKE, TX 78133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| J O MCDONALD3 Filed as: J. O. MCDONALD | 2404 FAIR AVE. BEXLEY, OH 43209 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| HARLEY J MURRAY3 Filed as: HARLEY J. MURRAY | 705 N. STATE ST. WESTERVILLE, OH 43082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| KENNETH H LESLIE3 Filed as: KENNETH H. LESLIE | 1248 WESTHILL DRIVE COLUMBUS, OH 43213 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| JAMES D SAMS3 Filed as: JAMES D. SAMS | 233 MOORELAND ROAD BELPRE, OH 45714 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| IMPELMAN INS AND INVESTMENTS3 Filed as: IMPELMAN INSURANCE AND INVEST. SER. | 9311 SAN PEDRO SAN ANTONIO, TX 78216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| RICHARD CLOSE3 | 3656 LAKESTONE CIRCLE HILLIARD, OH 43026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| CHARLES D MERS AND ASSOC3 Filed as: CHARLES D. MERS AND ASSOC. | P.O. BOX 986 WESTERVILLE, OH 43086 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| WILLIAM H. MEYER AGENCY, INC.3 | 1660 NW PROFESSIONAL PLAZA, STE. J COLUMBUS, OH 43220 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 16.19% |
| WILLIAM H. MEYER AGENCY, INC.3 | 1660 NW PROFESSIONAL PLAZA, STE. J COLUMBUS, OH 43220 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 21.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | — | $257K |
| QUALITY CARE PARTNERS EIN 31-1435470 CONTRACT | Other fees Service code 99 | — | $178K |
| MEDICAL BENEFITS MUTUAL EIN 31-4210910 CONTRACT | Other fees Service code 99 | — | $31K |
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 | 1,671 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,671 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUPERIOR DENTAL CARE, INC. | 2,802 | $648K |
| Vision | VISION SERVICE PLAN | 942 | $461K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,907 | $1.6M |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,907 | $1.4M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,907 | $1.2M |
| Stop-loss / reinsurancereinsurance | AMERICAN ALTERNATIVE INSURANCE CORPORATION | 1,210 | $410K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,907 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,907 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.