| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER I | 2101 FLORENCE AVE CINCINNATI, OH 45206 | UNITEDHEALTHCARE INSURANCE COMPANY | $9K | $55K | $64K | 2.68% |
| VODES LLC3 Filed as: VODES BENEFITS | 7333 PARAGON ROAD, SUITE 190 DAYTON, OH 45459 | SIRIUS AMERICA INSURANCE COMPANY | $11K | — | $11K | 4.87% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 | 1487 COURTYARD PL CENTERVILLE, OH 454583975 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 8.66% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY | 3931 S. DIXIE DR. DAYTON, OH 454392313 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $1K | $8K | 33.55% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 Filed as: DEMORAY BENEFIT ADMINSTRATORS | 1487 COURTYARD PLACE CENTERVILLE, OH 45458 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.24% |
| DEMORAY BENEFIT ADMINISTRATORS INC3 Filed as: DEMORAY BENEFIT ADMIN INC | 1487 COURTYARD PL CENTERVILLE, OH 454583975 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.89% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $150 | — | $150 | 2.66% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $104 | — | $104 | 1.84% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $80 | — | $80 | 1.42% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $50 | — | $50 | 0.89% |
| DAVE MAUTE3 | 2200 E MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $45 | — | $45 | 0.80% |
| VINURA AGENCY LLC3 | PO BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $28 | — | $28 | 0.50% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | — | $24 | 0.43% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | — | $20 | 0.35% |
| JAMES L HALSEY3 | 119 N MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.34% |
| DOUGLAS SMITH3 | 2713 WOODFORD DR SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.34% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.23% |
| JAMES L HALSEY3 | 119 N MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6 | — | $6 | 0.11% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.07% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.07% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.05% |
| VINURA AGENCY LLC3 | P.O. BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.04% |
| DOUGLAS SMITH3 | 2713 WOODFORD DR. SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $76 | — | $76 | 2.30% |
| DAVE MAUTE3 | 2200 E. MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $72 | — | $72 | 2.18% |
| ERICA LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $64 | — | $64 | 1.94% |
| ERICA J LEONHARDT3 Filed as: ERICA J LEONARDT | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27 | — | $27 | 0.82% |
| DAVE MAUTE3 | 2200 E. MAIN STREET SPRINGFIELD, OH 45503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | — | $24 | 0.73% |
| VINURA AGENCY LLC3 | P.O. BOX 102 WADSWORTH, OH 44282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | — | $16 | 0.48% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | — | $16 | 0.48% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.39% |
| JAMES L HALSEY3 | 119 N. MAIN ST. UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.33% |
| DOUGLAS E SMITH3 | 2713 WOODFORD DR. SPRINGFIELD, OH 455031949 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | — | $7 | 0.21% |
| THOMAS W BOSTON3 Filed as: THOMAS W. BOSTON | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | — | $7 | 0.21% |
| ARMIN G LEONHARDT3 Filed as: ARMIN G. LEONHARDT | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.12% |
| JAMES L HALSEY3 | 119 N. MAIN ST UNION, OH 45322 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.12% |
| THOMAS W BOSTON3 | 13661 MARKET AVE. N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.06% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNDERWRITERS SERVICES CORPORATION EIN 90-0345133 NONE | Contract Administrator; Claims processing Service code 12 | — | $9K |
| DELTA DENTAL OF OHIO EIN 31-0685339 NONE | Claims processing; Contract Administrator Service code 12 | — | $7K |
| MMO EIN 34-0648820 NONE | Contract Administrator; Claims processing Service code 12 | — | $5K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Claims processing; Insurance brokerage commissions and fees; Contract Administrator Service code 12 | — | $2K |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 337 | $2.4M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 345 | $23K |
| Life insurance(3 contracts, 2 carriers) | SIRIUS AMERICA INSURANCE COMPANY | 197 | $371K |
| Short-term disability(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $147K |
| Long-term disability(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $172K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 35 | $224K |
| Other(2 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 20 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 345 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.