| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEONARD ADAMS INSURANCE INC3 Filed as: LEONARD INSURANCE SERVICES | 4244 MT PLEASANT ST NW NORTH CANTON, OH 44720 | AULTCARE INSURANCE COMPANY | $17K | — | $17K | 2.07% |
| SIRAK FINANCIAL SERVICES3 | 4700 DRESSLER RD NW CANTON, OH 44718 | AULTCARE INSURANCE COMPANY | $5K | — | $5K | 11.11% |
| LEONARD ADAMS INSURANCE INC3 Filed as: LEONARD INSURANCE SERVICES | 4244 MT PLEASANT ST NW NORTH CANTON, OH 44720 | AMERICAN UNITED LIFE INSURANCE COMPANY | $4K | — | $4K | 11.00% |
| JOAN ANNE HENDERSON3 Filed as: JOAN HENDERSON | 2331 AMBERWOOD CIR NE MASSILLON, OH 44646 | AFLAC | $2K | $131 | $2K | 13.84% |
| THERESA L GOIK3 Filed as: THERESA GOIK | 1816 W NIGHTHAWK WAY PHOENIX, AZ 85045 | AFLAC | $395 | — | $395 | 3.17% |
| SHELLY BALL3 | 9 STOUTENBURG DR NORWALK, OH 44857 | AFLAC | $318 | $26 | $344 | 2.76% |
| A C LONG & ASSOCIATES INC3 | 1113 MEDINA RD STE 500 MEDINA, OH 44256 | AFLAC | $263 | $26 | $289 | 2.32% |
| ANGELA FANKHAUSER3 | 6000 BUCKBOARD LN SOLON, OH 44139 | AFLAC | $236 | — | $236 | 1.89% |
| HARE AND ASSOCIATES LLC3 | 470 OLDE WORTHINGTON RD STE 250 WESTERVILLE, OH 43082 | AFLAC | $113 | $26 | $139 | 1.12% |
| STEPHEN BRIAN LOMBARDOZZI3 Filed as: STEPHEN LOMBARDOZZI | 5329 GARGASZ DR LORAIN, OH 44053 | AFLAC | $93 | — | $93 | 0.75% |
| WILLIAM HERDER3 | 112 EDMONTON RD BELLVILLE, OH 44813 | AFLAC | $74 | — | $74 | 0.59% |
| KATHERINE ROSE LANG3 Filed as: KATHERINE LANG | 21617 HALWORTH RD BEACHWOOD, OH 44122 | AFLAC | $59 | — | $59 | 0.47% |
| MARC J HAIRE3 | 9885 GREENHAVEN PARKWAY BRECKSVILLE, OH 44141 | AFLAC | $53 | — | $53 | 0.43% |
| SCOTT A SMITH3 Filed as: SCOTT SMITH | 5399 OAKBROOK PKWY STE 300 STE 350 NORCROSS, GA 30093 | AFLAC | $35 | — | $35 | 0.28% |
| HENSLEY AND ASSOCIATES LLC3 | 1103 SCHROCK RD STE 201 COLUMBUS, OH 43229 | AFLAC | $26 | — | $26 | 0.21% |
| BRUCE MEYER3 | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $17 | — | $17 | 0.14% |
| GARY A SPANRAFT3 Filed as: GARY SPANRAFT | 58 GREENHEDGE CIR DELAWARE, OH 43015 | AFLAC | $16 | — | $16 | 0.13% |
| JAMES A TAFT JR3 Filed as: JAMES TAFT JR | 573 CANE RUN ST HARRODSBURG, KY 40330 | AFLAC | $9 | — | $9 | 0.07% |
| BONNIE L TAFT3 | 573 CANE RUN ST HARRODSBURG, KY 40330 | AFLAC | $6 | — | $6 | 0.05% |
| JOHN LUTZ3 | 19646 N 92ND AVENUE PEORIA, AZ 85382 | AFLAC | $3 | — | $3 | 0.02% |
| JUDY KAUFFMAN3 | PO BOX 135 NEW WILMINGTON, PA 16142 | AFLAC | $3 | — | $3 | 0.02% |
| RUSSELL O. ULRICH JR.3 Filed as: RUSSELL O ULRICH JR | 150 N MILLER RD STE 300 A FAIRLAWN, OH 44333 | AFLAC | $2 | — | $2 | 0.02% |
| JOHN D PETTIGREW3 | 1620 COHASSET DR CINCINNATI, OH 45255 | AFLAC | $1 | — | $1 | 0.01% |
| LEONARD ADAMS INSURANCE INC3 Filed as: LEONARD INSURANCE SERVICES | 5469 MT PLEASANT ST NW NORTH CANTON, OH 44720 | AULTCARE INSURANCE COMPANY | $1K | — | $1K | 11.32% |
| SIRAK FINANCIAL SERVICES3 | 4700 DRESSLER RD NW CANTON, OH 44718 | AULTCARE INSURANCE COMPANY | -$24 | — | -$24 | -0.21% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AULTCARE INSURANCE COMPANY | 160 | $811K |
| Dental(2 contracts) | AULTCARE INSURANCE COMPANY | 163 | $57K |
| Vision(2 contracts) | AULTCARE INSURANCE COMPANY | 163 | $57K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 138 | $41K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 138 | $41K |
| Prescription drug | AULTCARE INSURANCE COMPANY | 160 | $811K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 138 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.