| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROKERS ALLIANCE OF OHIO INC3 | 105 MARINA POINT DRIVE SANDUSKY, OH 44870 | COMMUNITY INSURANCE COMPANY | $23K | $2K | $26K | 2.84% |
| BROKERS ALLIANCE OF OHIO INC3 | 105 MARINA POINT DR SUNDUSKY, OH 448706512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.97% |
| BRADLEY MELVIN3 | 2895 W CALLA RD CANFIELD, OH 44406 | AFLAC | $1K | $203 | $1K | 5.64% |
| USI INSURANCE SERVICES LLC3 | 312 ELM ST STE 2400 CINCINNATI, OH 45202 | AFLAC | $377 | — | $377 | 1.74% |
| BRADLEY KAUFFMAN3 | 315 GREEN RIDGE RD STE H1 NEW CASTLE, PA 16105 | AFLAC | $333 | — | $333 | 1.53% |
| LEON KOKAL3 | 10478 TOLLAND DR AURORA, OH 44202 | AFLAC | $298 | — | $298 | 1.37% |
| JUDY KAUFFMAN3 | PO BOX 135 NEW WILMINGTON, PA 16142 | AFLAC | $220 | — | $220 | 1.01% |
| MAKOWSKI INS AGCY INC3 | 9404 WOODCHIP LN BROADVIEW HTS, OH 44147 | AFLAC | $204 | — | $204 | 0.94% |
| MICHAEL YOST3 | PO BOX 14218 POLAND, OH 44514 | AFLAC | $162 | — | $162 | 0.75% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL EVANS JR | 3199 SIOUX CONIFER RD WATERTOWN, SD 57201 | AFLAC | $116 | — | $116 | 0.53% |
| LEWIS P AGNONE3 Filed as: LEWIS AGNONE | 360 EASTWOOD DR HUBBARD, OH 44425 | AFLAC | $67 | — | $67 | 0.31% |
| GEORGE C MALINKY3 Filed as: GEORGE MALINKY | 7000 NEW RD YOUNGSTOWN, OH 44515 | AFLAC | $52 | — | $52 | 0.24% |
| ASSOCIATION GROUP INSURANCE AGENCY3 Filed as: ASSOCIATION GROUP INS AGCY | PO BOX 126 NILES, OH 44446 | AFLAC | $38 | — | $38 | 0.17% |
| BARBARA ROSARIO3 | 236 COREY DR GIBSONIA, PA 15044 | AFLAC | $29 | — | $29 | 0.13% |
| THOMAS J HOUSER3 Filed as: THOMAS HOUSER | 2720 BRIARWOOD CT POLAND, OH 44514 | AFLAC | $28 | — | $28 | 0.13% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AFLAC | $24 | — | $24 | 0.11% |
| LAURIE AULT3 | 315 GREEN RIDGE RD STE H1 NEW CASTLE, PA 16105 | AFLAC | $22 | — | $22 | 0.10% |
| HARE AND ASSOCIATES LLC3 | 6324 TARTON FIELDS LN MASON, OH 45040 | AFLAC | $21 | — | $21 | 0.10% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL | 315 GREEN RIDGE RD STE H1 NEW CASTLE, PA 16105 | AFLAC | $19 | — | $19 | 0.09% |
| BRIAN TODD KAUFFMAN3 Filed as: BRIAN KAUFFMAN | 315 GREEN RIDGE RD STE H1 NEW CASTLE, PA 16105 | AFLAC | $16 | — | $16 | 0.07% |
| VIRGILIO ROSARIO JR3 | 3202 KINGSTON LN YOUNGSTOWN, OH 44511 | AFLAC | $10 | — | $10 | 0.05% |
| QUINN, MEYER & ASSOCIATES3 | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $6 | — | $6 | 0.03% |
| AARON BISCELLA3 | PO BOX 39 NEW WATERFORD, OH 44445 | AFLAC | $0 | — | $0 | 0.00% |
| JOHN MATHEWS3 | PO BOX 136 GIRARD, OH 44420 | AFLAC | $0 | — | $0 | 0.00% |
| BROKERS ALLIANCE OF OHIO INC3 | 105 MARINA POINT DR SANDUSKY, OH 448706512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| ASSURANCE AGENCY LTD3 Filed as: ARCURI & ASSOCIATES ASSURANCE AGENC | 400 W RAILROAD STREET SUITE 6 COLUMBIANA, OH 44408 | VISION SERVICE PLAN | $1K | — | $1K | 7.00% |
| BROKERS ALLIANCE OF OHIO INC3 | 105 MARINA POINT DR SANDUSKY, OK 448706512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $994 | — | $994 | 10.00% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 223 | $922K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 95 | $51K |
| Vision | VISION SERVICE PLAN | 93 | $18K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $31K |
| Other(3 contracts, 2 carriers) | AFLAC | 112 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.