| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEMORAY BENEFIT ADMINISTRATORS INC3 Filed as: DEMORAY BENEFITS ADMINISTRATORS | 1487 COURTYARD PLACE CENTERVILLE, OH 45458 | STANDARD LIFE | $35K | — | $35K | 10.95% |
| VODES LLC3 Filed as: VODES BENEFITS | 7333 PARAGON ROAD, SUITE 190 DAYTON, OH 45459 | STANDARD LIFE | $7K | — | $7K | 2.28% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 | 1487 COURTYARD PL CENTERVILLE, OH 454583975 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 14.99% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.80% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $865 | — | $865 | 3.57% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $358 | — | $358 | 1.48% |
| JAMES L HALSEY3 | 119 N MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $119 | — | $119 | 0.49% |
| VINURA AGENCY LLC3 | PO BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | — | $26 | 0.11% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 Filed as: DEMORAY BENEFIT ADMINSTRATORS | 1487 COURTYARD PLACE CENTERVILLE, OH 45458 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY INC | 3931 S DIXIE DRIVE DAYTON, OH 454392321 | HARTFORD LIFE AND ACCIDENT | $4K | $566 | $4K | 22.99% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 7.36% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $778 | — | $778 | 4.69% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $343 | — | $343 | 2.07% |
| THOMAS W BOSTON3 | 1275 WESY MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $315 | — | $315 | 1.90% |
| VINURA AGENCY LLC3 | PO BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $211 | — | $211 | 1.27% |
| JAMES L HALSEY3 | 119 N MAIN STREET UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $168 | — | $168 | 1.01% |
| SCHINDLER AGENCY LLC3 | 725 S DIXIE DR VANDALIA, OH 45377 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $43 | — | $43 | 0.26% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER SKS | 1 WEST FOURTH STREET, SUITE 1300 CINCINNATI, OH 45202 | DENTAL CARE PLUS, INC. | $2K | — | $2K | 11.30% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $639 | — | $639 | 4.08% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $626 | — | $626 | 4.00% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $375 | — | $375 | 2.40% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $332 | — | $332 | 2.12% |
| JAMES L HALSEY3 | 119 N MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $106 | — | $106 | 0.68% |
| VINURA AGENCY LLC3 | PO BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $97 | — | $97 | 0.62% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.11% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 Filed as: DEMORAY BENEFIT ADMIN INC | 1487 COURTYARD PL CENTERVILLE, OH 454583975 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 13.80% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $881 | — | $881 | 6.39% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $659 | — | $659 | 4.78% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $394 | — | $394 | 2.86% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $204 | — | $204 | 1.48% |
| JAMES L HALSEY3 | 119 N MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $120 | — | $120 | 0.87% |
| VINURA AGENCY LLC3 | PO BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $115 | — | $115 | 0.83% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | — | $22 | 0.16% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $237 | — | $237 | 4.09% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $225 | — | $225 | 3.88% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $200 | — | $200 | 3.45% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $74 | — | $74 | 1.28% |
| JAMES L HALSEY3 | 119 N MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $38 | — | $38 | 0.66% |
| VINURA AGENCY LLC3 | PO BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $30 | — | $30 | 0.52% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNDERWRITERS SERVICE CORPORATION EIN 90-0345133 NONE | Contract Administrator; Claims processing Service code 12 | — | $39K |
| MMO EIN 34-0648820 NONE | Claims processing; Contract Administrator Service code 12 | — | $38K |
| HEALTHSPAN EIN 31-1431434 NONE | Contract Administrator; Claims processing Service code 12 | — | $13K |
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 | 297 | 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) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 28 | $76K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF OHIO | 323 | $59K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 302 | $20K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 297 | $71K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 40 | $15K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 201 | $34K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE | 165 | $319K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.