| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E KEMMER3 Filed as: ROBERT KEMMER | P.O. BOX 352 BUFFALO, OH 43722 | AFLAC | $9K | $384 | $9K | 5.46% |
| W B GREEN & CO INC3 | 626 WHEELING AVE CAMBRIDGE, OH 43725 | AFLAC | $6K | — | $6K | 3.41% |
| GAYLORD I KAUFFMAN3 Filed as: GAYLORD KAUFFMAN | 315 GREEN RIDGE ROAD, SUITE H1 NEW CASTLE, PA 16105 | AFLAC | $1K | — | $1K | 0.82% |
| MARK D JONES3 Filed as: MARK JONES | 306 CUNNINGHAM RUN RD PENNSBORO, WV 26415 | AFLAC | $1K | — | $1K | 0.79% |
| JAMES A BURRESS3 | 6418 FAYBOROUGH CT DUBLIN, OH 43016 | AFLAC | $890 | $119 | $1K | 0.59% |
| HEATHER SONAGERE3 Filed as: HEATHER DAWN SONAGERE | 1032 BELFORD ST CALDWELL, OH 43724 | AFLAC | $879 | — | $879 | 0.51% |
| HARE AND ASSOCIATES LLC3 | 470 OLDE WORTHINGTON RD SUITE 250 WESTERVILLE, OH 43082 | AFLAC | $545 | $119 | $664 | 0.39% |
| MARK L HUFHAND3 Filed as: MARK HUFHAND | 3313 KEE ST NW NORTH CANTON, OH 44720 | AFLAC | $646 | — | $646 | 0.38% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA L MANY | 306 NORTHRIDGE RD APT 1 CIRCLEVILLE, OH 43113 | AFLAC | $402 | $58 | $460 | 0.27% |
| JORDAN FUNK3 | 1600 HERITAGE LANDING, STE. 115 ST. CHARLES, MO 63303 | AFLAC | $430 | — | $430 | 0.25% |
| LINDA L LEONARD3 Filed as: LINDA LEONARD | 448 PRIVATE RD 3290 SOUTH POINT, OH 45680 | AFLAC | $351 | — | $351 | 0.21% |
| JACK A SHADE3 | 690 TREE BEND CT WESTERVILLE, OH 43082 | AFLAC | $349 | — | $349 | 0.20% |
| QUINN, MEYER & ASSOCIATES3 | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $324 | — | $324 | 0.19% |
| MARK A SHERBY3 Filed as: MARK SHERBY | 293 S 4TH STREET BYESVILLE, OH 43723 | AFLAC | $323 | — | $323 | 0.19% |
| KAREN SUTPHIN3 | 81 TABLE ROCK LANE WHEELING, WV 26003 | AFLAC | $214 | — | $214 | 0.13% |
| BRUCE MEYER3 | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $202 | — | $202 | 0.12% |
| SCOTT A SMITH3 | 5300 OAKBROOK PKWY BLDG 300 STE 350 NORCROSS, GA 30093 | AFLAC | $199 | — | $199 | 0.12% |
| PENNY NICHOLSON3 | 209 KENWOOD AVE MARIETTA, OH 45750 | AFLAC | $144 | — | $144 | 0.08% |
| DUSTIN P WILSON3 | 62900 DUSTY LN BARNESVILLE, OH 43713 | AFLAC | $132 | — | $132 | 0.08% |
| ABBY CORDER3 | 1165 GREINER RD ZANESVILLE, OH 43701 | AFLAC | $116 | — | $116 | 0.07% |
| RONALD JAMES STEIN3 | 2740 AIRPORT DR STE 170 COLUMBUS, OH 43219 | AFLAC | $90 | — | $90 | 0.05% |
| JOSHUA K HOPPE3 | 580 WHITE PLAINS RD STE 115 STE 170 TARRYTOWN, NY 10591 | AFLAC | $85 | — | $85 | 0.05% |
| MICHAEL TAYLOR3 | 7111 35TH ST E SARASOTA, FL 34243 | AFLAC | $83 | — | $83 | 0.05% |
| GREGORY F STENZEL3 | 6800 STONY HILL RD MCKINNEY, TX 75070 | AFLAC | $69 | — | $69 | 0.04% |
| LUCI WILLIAMS3 | 637 WILEY AVE BARNESVILLE, OH 43713 | AFLAC | $55 | — | $55 | 0.03% |
| JOHN F ADAMSKY3 Filed as: JOHN ADAMSKY | PO BOX 6164 NEW PHILADELPHIA, OH 44663 | AFLAC | $35 | — | $35 | 0.02% |
| ENROLLEASE3 Filed as: MICHAEL A CLARKE | 3066 VENTURE LN ZANESVILLE, OH 43071 | AFLAC | $20 | $5 | $25 | 0.01% |
| MELISSA SUE DALRYMPLE3 | 737 SMITH RD WATERFORD, OH 45786 | AFLAC | $23 | — | $23 | 0.01% |
| NICHOLAS PETRYCKI3 | 8141 LARKSPUR AVE NW N CANTON, OH 44720 | AFLAC | $19 | — | $19 | 0.01% |
| HOLLY JEAN ROREM3 Filed as: HOLLY J ROREM INC | 431 NASH LANE PORT ORANGE, FL 32127 | AFLAC | $6 | — | $6 | 0.00% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 1301 SOUTH SUMMIT AVE SIOUX FALLS, SD 57105 | AFLAC | $6 | — | $6 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL QUINN | 8580 MAJORCA LANE NAPLES, FL 34114 | AFLAC | $5 | — | $5 | 0.00% |
| SCOTT D HAWKINS INC3 | 5951 PEGGY BARROW CT PORT ORANGE, FL 32127 | AFLAC | $4 | — | $4 | 0.00% |
| KRIS D SHADE3 | 690 TREE BEND CT WESTERVILLE, OH 43082 | AFLAC | $3 | — | $3 | 0.00% |
| JENNIE MOORE HAWKINS3 Filed as: JENNIE M HAWKINS INC | 3930 S NOVA RD STE 201 PORT ORANGE, FL 32127 | AFLAC | $3 | — | $3 | 0.00% |
| ROBERT L TRAPNELL JR3 | 15 N INDIAN RIVER DRIVE 705 COCOA, FL 32922 | AFLAC | $1 | — | $1 | 0.00% |
| FRANK J DOSCH3 Filed as: FRANK J. DOSCH | 964 GROVE RD ZANESVILLE, OH 43701 | NORTHWESTERN MUTUAL | $4K | $888 | $4K | 11.28% |
| KEMELGOR FNCL GRP INC3 | 800 YARD ST, SUITE 300 COLUMBUS, OH 43212 | NORTHWESTERN MUTUAL | $797 | $82 | $879 | 2.22% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - IND | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $537 | $336 | $873 | 2.98% |
| THE FORKER COMPANY3 Filed as: THE FORKER AGENCY INC | P.O. BOX 2040 ZANESVILLE, OH 437022040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $697 | — | $697 | 2.38% |
| VHA CENTRAL INSURANCE SERVICES3 | 8900 KEYSTONE CROSSING SUITE 480 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $269 | $201 | $470 | 1.61% |
| W B GREEN & CO INC3 Filed as: W. B. GREEN & CO INC | 626 WHEELING AVENUE CAMBRIDGE, OH 43725 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $485 | — | $485 | 2.31% |
| WILLIAM H. MEYER AGENCY, INC.3 Filed as: WILLIAM H. MEYER AGY INC | 1660 NW PROFESSIONAL PLAZA COLUMBUS, OH 43220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $316 | — | $316 | 1.50% |
| JAMES R THOMAS SR3 Filed as: JAMES THOMAS | 5451 ST ANDREWS DRIVE WESTERVILLE, OH 43082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | — | $127 | 0.60% |
| DWAINE K HOWELL3 Filed as: DWAINE HOWELL | 79 LAKEVIEW DRIVE THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.23% |
| HEALTHCARE REFORM ALTERNATIVES LLC3 | 2706 BAR HARBOUR CT LEWIS CENTER, OH 43035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.22% |
| DOUGLAS WAGONER3 | PO BOX 157 HILLSBORO, OH 45133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.16% |
| KEVIN D HOWELL3 Filed as: KEVIN HOWELL | 60 WEST COLUMBUS ST THORNVILLE, OH 43076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.15% |
| HARLEY J MURRAY3 Filed as: HARLEY MURRAY | 705 N STATE ST WESTERVILLE, OH 43082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.12% |
| RICHARD CLOSE3 | 3656 LAKESTONE CIRCLE HILLIARD, OH 43026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.12% |
| DAVID L DUNCAN3 Filed as: DAVID DUNCAN | 3106 DREW DRIVE HAMILTON, OH 45011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.11% |
| PETERSON FINANCIAL INC3 Filed as: PETERSON FINANCIAL INC. | 605 BRADY AVENUE STEUBENVILLE, OH 43952 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.09% |
| WILLIAM T. DUNCAN3 Filed as: WILLIAM DUNCAN | 2209 LINDEN AVENUE MIDDLETOWN, OH 45044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| DAVID J MCCLELLAN3 Filed as: DAVID SMELCER | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| THE FORKER COMPANY3 Filed as: THE FORKER AGENCY INC | PO BOX 2040 ZANESVILLE, OH 43702 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $200 | — | $200 | 11.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - IND | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33 | $21 | $54 | 3.23% |
| VHA CENTRAL INSURANCE SERVICES3 | 8900 KEYSTONE CROSSING STE 480 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | $13 | $30 | 1.80% |
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 | 760 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 26 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 796 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AFLAC | 244 | $171K |
| Vision(2 contracts, 2 carriers) | AFLAC | 519 | $249K |
| Life insurance(4 contracts, 3 carriers) | AFLAC | 638 | $223K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 244 | $192K |
| Long-term disability | NORTHWESTERN MUTUAL | 71 | $40K |
| Other(4 contracts, 3 carriers) | AFLAC | 638 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 638 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.