| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | THE GUARDIAN LIFE INSURANCE COMPANY | $4K | $3K | $7K | 12.20% |
| PEOPLES INSURANCE AGENCY, LLC3 | 124 PUTNAM STREET P.O. BOX 210 JACKSON, OH 45640 | AFLAC | $2K | $0 | $2K | 6.81% |
| KIMBERLY NIETO3 | 5419 CLUB DRIVE WESTERVILLE, OH 43082 | AFLAC | $2K | $67 | $2K | 5.98% |
| DONNA LIVINGSTON3 Filed as: DONNA LININGSTON AND OTHER AGENTS | 402 HANSEGEN MORGAN ROAD WHEELERSBURG, OH 45694 | AFLAC | $1K | $77 | $1K | 4.04% |
| ADRIENNE ALICE MENCHACA HOLBROOK3 | UNKNOWN JACKSON, OH 45640 | AFLAC | $608 | $722 | $1K | 3.94% |
| STEVE NIETO3 | UNKNOWN JACKSON, OH 45640 | AFLAC | $1K | $42 | $1K | 3.39% |
| KELLI WILLIAMS AND OTHER AGENTS3 Filed as: KELLI WILLIAMS | UNKNOWN JACKSON, OH 45640 | AFLAC | $451 | $4 | $455 | 1.35% |
| CAMERON CARRILLO3 Filed as: CAMERON D CARRILLO | 5801 WESTCHESTER CT WORTHINGTON, OH 43085 | AFLAC | $369 | $2 | $371 | 1.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | THE GUARDIAN LIFE INSURANCE COMPANY | $1K | $642 | $2K | 15.44% |
| PEOPLES INSURANCE AGENCY, LLC3 | DBA BARENGO INSURANCE P.O. BOX 210 MARIETTA, OH 45750 | AMERICAN HERITAGE LIFE (ALLSTATE) | $1K | $0 | $1K | 10.39% |
| MARLENE R. GUTTMAN, LLC3 Filed as: MARLENE R GUTTMAN LLC | UNKNOWN JACKSON, OH 45640 | AMERICAN HERITAGE LIFE (ALLSTATE) | $852 | $0 | $852 | 7.89% |
| ANGELA BETZ LIVERATI3 | PO BOX 1012 1105 TEODORA AVE GALLIPOLIS, OH 45631 | AMERICAN HERITAGE LIFE (ALLSTATE) | $247 | $0 | $247 | 2.29% |
| THOMAS W BOSTON3 | UNKNOWN JACKSON, OH 45640 | AMERICAN HERITAGE LIFE (ALLSTATE) | $32 | $0 | $32 | 0.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY | $1K | $633 | $2K | 15.93% |
| BAC AGENCY, INC.5 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE INSURANCE COMPANY | $841 | $0 | $841 | 10.04% |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIMERICA INSURANCE COMPANY | 87 | $251K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 123 | $60K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 123 | $60K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 200 | $23K |
| Short-term disability(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 200 | $33K |
| Prescription drug | UNIMERICA INSURANCE COMPANY | 87 | $240K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 87 | $240K |
| Other(2 contracts, 2 carriers) | AFLAC | 87 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.