| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD D SOMMER3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | MEDICAL MUTUAL | $30K | $0 | $30K | 1.25% |
| REB CONSULTING, INC.3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | MEDICAL MUTUAL | $15K | $0 | $15K | 0.61% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | STANDARD INSURANCE COMPANY | $7K | $0 | $7K | 7.66% |
| REB CONSULTING, INC.3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 3.40% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AGENCY & FINA | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.00% |
| EDWARD D SOMMER3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.20% |
| REB CONSULTING, INC.3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | METROPOLITAN LIFE INSURANCE COMPANY | $629 | $0 | $629 | 0.87% |
| OVERALL BENEFITS GROUP LLC3 | 324 STRAW COURT PATASKALA, OH 43062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $37 | $3K | 7.29% |
| EDWARD D SOMMER3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $5 | $1K | 3.70% |
| LISA R CANFIELD3 | 9255 HIGH POINT ROAD THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $409 | $8 | $417 | 1.18% |
| JUSTIN J MCDONALD3 Filed as: JUSTIN J MCONALD | 12052 PEPPERMILL LANE PICKERINGTON, OH 43147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $263 | $2 | $265 | 0.75% |
| DANIEL THOMAS CANFIELD3 | 9255 HIGH POINT ROAD THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $263 | $2 | $265 | 0.75% |
| REB CONSULTING, INC.3 | 300 WEST WILSON BRIDGE ROAD SUITE 300 WORTHINGTON, OH 43085 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | $0 | $126 | 0.36% |
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO3 | 10589 LAGUNA CIRCLE PLAIN CITY, OH 43064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.20% |
| JENNIFER LOEFFLER3 | 4455 MASON ROAD CANAL WINCHESTER, OH 43110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $7 | $49 | 0.14% |
| MELISSA SUE LEONARDI3 | 65 N. DIXIE DRIVE SUITE A VANDALIA, OH 45377 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.05% |
| SCOTT THOMAS LEONARDI3 | 65 N. DIXIE DRIVE SUIE 5 VANDALIA, OH 45377 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| D STEVEN SMELCER3 | 7676 MEHAFFEY RAOD LIMA, OH 43801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| DAVID L SMELCER3 | PO BOX 356 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $3K |
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 | 182 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 135 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 499 | $72K |
| Vision | STANDARD INSURANCE COMPANY | 182 | $98K |
| Life insurance | STANDARD INSURANCE COMPANY | 182 | $98K |
| Long-term disability | STANDARD INSURANCE COMPANY | 182 | $98K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 40 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 499 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.