| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON MYERS & ASSOCIATES INC3 Filed as: GIBSON MYERS AND ASSOCIATES, INC. | 2876 S. ARLINGTON ROAD AKRON, OH 44312 | MEDICAL MUTUAL | $29K | $8 | $29K | 2.40% |
| ADRIENNE E VAUGHAN3 | 5224 BECKETTE RIDGE STOW, OH 44224 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $5K | $13K | 11.02% |
| DAVID CAMPANA INSURANCE LTD3 Filed as: DAVID L CAMPANA INS LTD | 341 COPPER CREEK AMHERST, OH 44001 | ALLSTATE | $599 | — | $599 | 4.10% |
| ADRIENNE E VAUGHAN3 Filed as: ADRIENNE E VAUGHN | PO BOX 1607 STOW, OH 44224 | ALLSTATE | $379 | — | $379 | 2.59% |
| TOM DENNISON AGENCY INC3 | 3034 CLIFFSIDE DR COPLEY, OH 44321 | ALLSTATE | $330 | — | $330 | 2.26% |
| BAYSIDE BFT SOLUTIONS LLC3 Filed as: BAYSIDE BENEFIT SOLUTIONS LLC | 309 FOREST BREEZE AVE BRANDON, FL 33511 | ALLSTATE | $222 | — | $222 | 1.52% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE DR SUITE H 1 NEW CASTLE, PA 16015 | ALLSTATE | $75 | — | $75 | 0.51% |
| THOMAS W BOSTON3 | 1275 WEST MAPLE ST HARTVILLE, OH 44632 | ALLSTATE | $68 | — | $68 | 0.47% |
| LYNN ANN SHEA3 | 912 BEL AIR DR NW NORTH CANTON, OH 44720 | ALLSTATE | $46 | — | $46 | 0.31% |
| ELIZABETH J. TEPPER3 Filed as: ELIZABETH J TEPPER | 2223 N JEFFERSON BLVD LORAIN, OH 44052 | ALLSTATE | $24 | — | $24 | 0.16% |
| MICHAEL W BERUBE3 | ENROLLPAD 1300 CHRISTMAS SEAL DR. CANTON, OH 44709 | ALLSTATE | $22 | — | $22 | 0.15% |
| MARK L HUFHAND3 | 3313 LEE ST NORTH CANTON, OH 44720 | ALLSTATE | $22 | — | $22 | 0.15% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BFTS INC. | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | ALLSTATE | $19 | — | $19 | 0.13% |
| JENNIFER M CAMPANA3 | 341 COPPER CREEK AMHERST, OH 44001 | ALLSTATE | $8 | — | $8 | 0.05% |
| MICHAEL C HURLEY3 | 7484 STATE ROUTE 195 ALGER, OH 45812 | ALLSTATE | $1 | — | $1 | 0.01% |
| DAVID CAMPANA INSURANCE LTD3 Filed as: DAVID L CAMPANA JR | 6155 PARK SQUARE DRIVE SUITE 7 LORAIN, OH 44053 | ALLSTATE | $81 | — | $81 | 0.86% |
| TOM DENNISON AGENCY INC3 | 3034 CLIFFSIDE DRIVE COPLEY, OH 44321 | ALLSTATE | $62 | — | $62 | 0.66% |
| BAYSIDE BFT SOLUTIONS LLC3 | 309 FOREST BREEZE AVENUE BRANDON, FL 33511 | ALLSTATE | $58 | — | $58 | 0.62% |
| ADRIENNE E VAUGHAN3 Filed as: ADRIENNE E VAUGHN | PO BOX 1607 STOW, OH 44224 | ALLSTATE | $56 | — | $56 | 0.60% |
| THOMAS W BOSTON3 Filed as: THOMAS W. BOSTON | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | ALLSTATE | $28 | — | $28 | 0.30% |
| LYNN ANN SHEA3 | 912 BEL AIR DR NW N CANTON, OH 44720 | ALLSTATE | $13 | — | $13 | 0.14% |
| JENNIFER M CAMPANA3 | 341 COPPER CREEK AMHERST, OH 44001 | ALLSTATE | $4 | — | $4 | 0.04% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BENEFITS INC | 3601 GREEN ROAD SUITE 320 BEACHWOOD, OH 44122 | ALLSTATE | $3 | — | $3 | 0.03% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 6.02% |
| HELEN DIZ-HATTON3 Filed as: HELEN E MCCREADY | 1767 25TH STREET CUYAHOGA FALLS, OH 44223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 1100 SUPERIOR AVE EAST CLEVELAND, OH 44114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GEORGE HORNE | 3410 MAGNOLIA WAY BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.08% |
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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL | 112 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 163 | $115K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 163 | $115K |
| Life insurance(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 163 | $132K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 163 | $115K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 163 | $115K |
| Prescription drug | MEDICAL MUTUAL | 112 | $1.2M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 163 | $125K |
| 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.