| 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 | $30K | $43 | $30K | 2.39% |
| ADRIENNE E VAUGHAN3 | 5224 BECKETTE RIDGE STOW, OH 44224 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 6.89% |
| DAVID CAMPANA INSURANCE LTD3 Filed as: DAVID L CAMPANA JR | 6155 PARK SQUARE DRIVE SUITE 7 LORAIN, OH 44053 | ALLSTATE | $1K | — | $1K | 5.98% |
| ADRIENNE E VAUGHAN3 Filed as: ADRIENNE E VAUGHN | PO BOX 1607 STOW, OH 44224 | ALLSTATE | $743 | — | $743 | 3.77% |
| TOM DENNISON AGENCY INC3 | 3034 CLIFFSIDE DRIVE COPLEY, OH 44321 | ALLSTATE | $577 | — | $577 | 2.93% |
| BAYSIDE BFT SOLUTIONS LLC3 | 309 FOREST BREEZE AVENUE BRANDON, FL 33511 | ALLSTATE | $296 | — | $296 | 1.50% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE DRIVE SUITE H-1 NEW CASTLE, PA 16015 | ALLSTATE | $211 | — | $211 | 1.07% |
| THOMAS W BOSTON3 Filed as: THOMAS W. BOSTON | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | ALLSTATE | $99 | — | $99 | 0.50% |
| LYNN ANN SHEA3 | 912 BEL AIR DR NW N CANTON, OH 44720 | ALLSTATE | $62 | — | $62 | 0.31% |
| MARK L HUFHAND3 | 1300 CHRISTMAS SEAL DR NW CANTON, OH 44709 | ALLSTATE | $61 | — | $61 | 0.31% |
| ELIZABETH J. TEPPER3 Filed as: ELIZABETH J TEPPER | 2223 N JEFFERSON BLVD LORAIN, OH 44052 | ALLSTATE | $61 | — | $61 | 0.31% |
| MICHAEL W BERUBE3 | 339 23RD STREET CANTON, OH 44709 | ALLSTATE | $61 | — | $61 | 0.31% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BENEFITS INC | 3601 GREEN ROAD SUITE 320 BEACHWOOD, OH 44122 | ALLSTATE | $34 | — | $34 | 0.17% |
| JENNIFER M CAMPANA3 | 341 COPPER CREEK AMHERST, OH 44001 | ALLSTATE | $13 | — | $13 | 0.07% |
| MICHAEL C HURLEY3 | 7484 STATE ROUTE 195 ALGER, OH 45812 | ALLSTATE | $1 | — | $1 | 0.01% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $206 | — | $206 | 6.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 1100 SUPERIOR AVE EAST CLEVELAND, OH 44114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.87% |
| HELEN DIZ-HATTON3 Filed as: HELEN E MCCREADY | 1767 25TH STREET CUYAHOGA FALLS, OH 44223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GEORGE HORNE | 3410 MAGNOLIA WAY BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.39% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL | 117 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $114K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $114K |
| Life insurance(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $137K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $114K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $114K |
| Prescription drug | MEDICAL MUTUAL | 117 | $1.2M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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.