| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 4500 TOWN CENTER BOULEVARD SUITE 200 JEFFERSONVILLE, IN 47130 | COMMUNITY INSURANCE COMPANY | $21K | $986 | $22K | 1.95% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN MARQUIS AGENCY, INC. | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | $780 | $0 | $780 | 0.07% |
| JANET LYNN HORSTMAN3 Filed as: JANET L. HORSTMAN | 285 GLENWORTH COURT POWELL, OH 43065 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | $0 | $19K | 2.97% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY | 4000 SMITH ROAD, SUITE 400 CINCINNATI, OH 45209 | AMERICAN UNITED LIFE INSURANCE COMPANY | $7K | $0 | $7K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF PA, INC. | 125 EAST ELM STREET, SUITE 210 CONSHOHOCKEN, PA 19428 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 5.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY, INC. | 595 STEWART AVENUE, SUITE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $0 | $238 | $238 | 1.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF PA, INC. | 125 EAST ELM STREET, SUITE 210 CONSHOHOCKEN, PA 19428 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 12.75% |
| ALPHA BENEFITS GROUP INC3 Filed as: ALPHA BENEFITS GROUP, INC. | UNKNOWN DUBLIN, OH 43017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $480 | $480 | 3.78% |
| INDEPENDENCE PLANNING GROUP3 Filed as: INDEPENDENCE PLANNING GROUP, LLC | 1767 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8 | $0 | $8 | 0.06% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF PA, INC. | 170 SOUTH INDEPENDENCE MALL WEST APARTMENT 805 PHILADELPHIA, PA 19106 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $554 | $2K | 14.92% |
| JANET LYNN HORSTMAN3 Filed as: JANET L. HORSTMAN | 285 GLENWORTH COURT POWELL, OH 43065 | SUN LIFE ASSURANCE COMPANY OF CANADA | $832 | $0 | $832 | 7.98% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY | 4000 SMITH ROAD, SUITE 400 CINCINNATI, OH 45209 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $947 | $0 | $947 | 10.00% |
| INSURANCE ASSOCIATES PLUS, INC.3 | 6903 HUMMINGBIRD DRIVE MASON, OH 45040 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $467 | $0 | $467 | 4.93% |
| GA SOLUTIONS LLC3 Filed as: EB SOLUTIONS, LLC | 4088 MAIN STREET HILLIARD, OH 43026 | HARTFORD LIFE AND ACCIDENT | $1K | $0 | $1K | 15.00% |
| MARK T. HORSTMAN3 | 285 GLENWORTH COURT POWELL, OH 43065 | HUMANA INSURANCE COMPANY | $454 | $0 | $454 | 6.00% |
| JANET LYNN HORSTMAN3 Filed as: JANET L. HORSTMAN | 285 GLENWORTH COURT POWELL, OH 43065 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $538 | $0 | $538 | 11.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY, INC. | UNKNOWN DUBLIN, OH 43017 | AMERICAN UNITED LIFE INSURANCE COMPANY | $169 | $0 | $169 | 4.36% |
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 | 346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | COMMUNITY INSURANCE COMPANY | 346 | $1.8M |
| Dental(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 346 | $40K |
| Vision(4 contracts, 3 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 346 | $9K |
| Life insurance(6 contracts, 5 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 223 | $90K |
| Short-term disability(3 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 223 | $55K |
| Long-term disability(3 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 223 | $55K |
| Prescription drug(3 contracts, 3 carriers) | COMMUNITY INSURANCE COMPANY | 346 | $1.8M |
| Other(6 contracts, 5 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 223 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 346 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.