| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PEOPLES INSURANCE AGENCY, LLC3 Filed as: PEOPLES INSURANCE AGENCY LLC | 124 PUTNAM STREET MARITTA, OH 45750 | MEDICAL MUTUAL | $47K | $15K | $62K | 2.06% |
| GRADY ENTERPRISES INC3 Filed as: GRADY ENTERPRISES INC. | 515 EAST MOUND STREET COLUMBUS OH, OH 43215 | MEDICAL MUTUAL | $12K | $7 | $12K | 0.39% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE COLUMBUS | 250 W. OLD WILSON BRIDGE ROAD SUITE 190 WORTHINGTON, OH 43085 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 0.14% |
| CBISA REACQUISITION CORP3 Filed as: CBISA REAQUISITION CORP | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 4.14% |
| EDWARD D SOMMER3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.50% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FINANCIAL | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.25% |
| EDWARD D SOMMER3 Filed as: EDWARD DA SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | NATIONWIDE LIFE INSURANCE COMPANY | $6K | $0 | $6K | 9.94% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $12 | $2K | 4.88% |
| LISA R CANFIELD3 Filed as: LISA R. CANFIELD | 324 STRAW COURT PATASKALA, OH 43062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $551 | $39 | $590 | 1.45% |
| HOWARD MESZAROS3 | 8680 COLVIN DRIVE PLAIN CITY, OH 43064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $470 | $0 | $470 | 1.15% |
| OVERALL BENEFITS GROUP LLC3 | 324 STRAW COURT PATASKALA, OH 43062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $359 | $90 | $449 | 1.10% |
| MARK CHRISTOPHER MOTZ3 | 85 EPERNAY AVE. PATASKALA, OH 43062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $175 | $0 | $175 | 0.43% |
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO3 | 10589 LAGUNA CIR PLAIN CITY, OH 43064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $0 | $100 | 0.25% |
| NATALIE J. FORD3 | 806 FAIRWOOD AVE. COLUMBUS, OH 43205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $0 | $54 | 0.13% |
| JENNIFER LOEFFLER3 | 4455 MASON ROAD CANAL WINCHESTER, OH 43110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $3 | $42 | 0.10% |
| D STEVEN SMELCER3 | 7676 MEHAFFEY ROAD LIMA, OH 45801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| DAVID L SMELCER3 Filed as: DAVID LEE SMELCER | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| PEOPLES INSURANCE AGENCY, LLC3 Filed as: PEOPLES INSURANCE AGENCY LLC | PO BOX 210 MARITTA, OH 45750 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.81% |
| EDWARD D SOMMER3 Filed as: EDWARD D.A. SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | VISION SERVICE PLAN | $245 | $0 | $245 | 0.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL | 136 | $5.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $142K |
| Vision | VISION SERVICE PLAN | 141 | $32K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $200K |
| Long-term disability | NATIONWIDE LIFE INSURANCE COMPANY | 176 | $58K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $241K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.