| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 | 800 YARD STREET SUITE 300 COLUMBUS, OH 43212 | COMMUNITY INSURANCE COMPANY | $4K | — | $4K | 4.95% |
| SHAWAN MARQUIS AGENCY INC3 | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | $475 | — | $475 | 0.53% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC EMPLOYEE BENEFITS SERVICE | — | COMMUNITY INSURANCE COMPANY | $212 | — | $212 | 5.01% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $81 | — | $81 | 8.25% |
| THOMAS C WILSON3 | 311 STONE RIDGE LANE PLAZA GAHANNA, OH 43230 | ALLSTATE | $34 | — | $34 | 3.46% |
| LINDA LEE BOSTON3 Filed as: LINDA LEE STALF-BOSTON | 13661 MARKET AVENUE NORTH HARTVILLE, OH 44632 | ALLSTATE | $14 | — | $14 | 1.43% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | ALLSTATE | $7 | — | $7 | 0.71% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $4 | — | $4 | 0.41% |
| DOUGLAS A BODKIN3 | 2647 PINE RUN LIMA, OH 45801 | ALLSTATE | $4 | — | $4 | 0.41% |
| KEITH A BEST3 | 2586 BRYTON COURT POWELL, OH 43065 | ALLSTATE | $3 | — | $3 | 0.31% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 | 800 YARD STREET SUITE 300 COLUMBUS, OH 43212 | ANTHEM LIFE INSURANCE COMPANY | $65 | — | $65 | 10.03% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $44 | — | $44 | 7.33% |
| THOMAS C WILSON3 | 311 STONE RIDGE LANE PLAZA GAHANNA, OH 43230 | ALLSTATE | $18 | — | $18 | 3.00% |
| LINDA LEE BOSTON3 Filed as: LINDA LEE STALF-BOSTON | 13661 MARKET AVENUE NORTH HARTVILLE, OH 44632 | ALLSTATE | $8 | — | $8 | 1.33% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | ALLSTATE | $4 | — | $4 | 0.67% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $2 | — | $2 | 0.33% |
| DOUGLAS A BODKIN3 | 2647 PINE RUN LIMA, OH 45801 | ALLSTATE | $2 | — | $2 | 0.33% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $28 | — | $28 | 5.61% |
| THOMAS C WILSON3 | 311 STONE RIDGE LANE PLAZA GAHANNA, OH 43230 | ALLSTATE | $12 | — | $12 | 2.40% |
| LINDA LEE BOSTON3 Filed as: LINDA LEE STALF-BOSTON | 13661 MARKET AVENUE NORTH HARTVILLE, OH 44632 | ALLSTATE | $5 | — | $5 | 1.00% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | ALLSTATE | $3 | — | $3 | 0.60% |
| KEITH A BEST3 | 2586 BRYTON COURT POWELL, OH 43065 | ALLSTATE | $2 | — | $2 | 0.40% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $1 | — | $1 | 0.20% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $10 | — | $10 | 3.83% |
| THOMAS C WILSON3 | 311 STONE RIDGE LANE PLAZA GAHANNA, OH 43230 | ALLSTATE | $9 | — | $9 | 3.45% |
| ARMIN G LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $9 | — | $9 | 3.45% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | ALLSTATE | $3 | — | $3 | 1.15% |
| LINDA LEE BOSTON3 Filed as: LINDA LEE STALF-BOSTON | 13661 MARKET AVENUE N HARTVILLE, OH 44632 | ALLSTATE | $2 | — | $2 | 0.77% |
| TAG BENEFITS GROUP LLC3 | 502 NORTH MAIN STREET #139 WEATHERFORD, TX 76086 | ALLSTATE | $2 | — | $2 | 0.77% |
| DOUGLAS A BODKIN3 | 2647 PINE RUN LIMA, OH 45801 | ALLSTATE | $1 | — | $1 | 0.38% |
| THOMAS C WILSON3 | 311 STONE RIDGE LANE PLAZA GAHANNA, OH 43230 | ALLSTATE | $1 | — | $1 | 4.35% |
| ERICA J LEONHARDT3 | 9000 FRANCINE LANE POWELL, OH 43065 | ALLSTATE | $1 | — | $1 | 4.35% |
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 | 98 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 82 | $90K |
| Dental | COMMUNITY INSURANCE COMPANY | 83 | $4K |
| Vision | COMMUNITY INSURANCE COMPANY | 82 | $90K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 99 | $648 |
| Other(6 contracts, 2 carriers) | ALLSTATE | 99 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.