| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | MEDICAL MUTUAL OF OHIO | $17K | $262 | $18K | 5.58% |
| HUMMEL GROUP INC3 | PO BOX 250 BERLIN, OH 44610 | MEDICAL MUTUAL OF OHIO | $5K | $528 | $6K | 1.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10 W CARMEL DR STE 260 CARMEL, IN 460323365 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 10.37% |
| HUMMEL GROUP INC3 | PO BOX 250 BERLIN, OH 446100250 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $3K | $4K | 6.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD GBS FINANCE 0 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $1K | — | $1K | 1.70% |
| HUMMEL GROUP INC3 | PO BOX 3 ORRVILLE, OH 44667 | DELTA DENTAL OF OHIO | $784 | — | $784 | 1.16% |
| ERIKA M PERRIN | 11565 GRENADA CIR NE HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 10.73% |
| KRISTEN MEDCALF MONROE | 5929 DARROW RD STE 3 HUDSON, OH 44236 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $486 | — | $486 | 1.69% |
| THOMAS W BOSTON | 18260 WINTERSET LN LORE CITY, OH 43755 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $238 | — | $238 | 0.83% |
| SHARON WOODS | 1570 HASTINGS CIRCLE NW UNIONTOWN, OH 44685 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $100 | — | $100 | 0.35% |
| BRIAN M KENNEDY | 1163 S FRANKLIN ST CHAGRIN FALLS, OH 44023 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $52 | — | $52 | 0.18% |
| BD CAPITAL PARTNERS LLC | 6450 ROCKSIDE WOODS BLVD S SUITE 250 INDEPENCE, OH 44131 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $41 | — | $41 | 0.14% |
| MAIN AVE INS AGENCY LLC | 4605 MAIN AVENUE ASHTABULA, OH 44004 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| CGI VOLUNTARY BENEFITS, INC. Filed as: CGI VOLUNTARY BFTS INC | 20046 WALKER ROAD 5 SHAKER HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $756 | — | $756 | 4.91% |
| HUMMEL GROUP INC3 | PO BOX 3 ORRVILLE, OH 446670003 | VISION SERVICE PLAN | $255 | — | $255 | 1.66% |
| LEA SWANSON4 | 7734 MORLEY RD MENTOR, OH 440606808 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $233 | — | $233 | 12.79% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 600084036 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $35 | — | $35 | 1.92% |
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 | 189 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 189 | $316K |
| Dental | DELTA DENTAL OF OHIO | 370 | $68K |
| Vision | VISION SERVICE PLAN | 162 | $15K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 265 | $73K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 265 | $73K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 265 | $73K |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 265 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.