| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | COMMUNITY INSURANCE COMPANY | $30K | — | $30K | 2.47% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE ROAD SUITE 300 INDEPENDENCE, OH 44131 | COMMUNITY INSURANCE COMPANY | — | $717 | $717 | 0.06% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | COMMUNITY INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE ROAD #300 INDEPENDENT, OH 44131 | COMMUNITY INSURANCE COMPANY | $1K | — | $1K | 1.50% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | ANTHEM LIFE INSURANCE COMPANY | $7K | — | $7K | 14.28% |
| ALPHA BENEFITS INC3 | 4200 ROCKSIDE ROAD #300 INDEPENDENCE, OH 44131 | ANTHEM LIFE INSURANCE COMPANY | $189 | — | $189 | 0.40% |
| PAULA CAMPBELL3 Filed as: PAULA W CAMPBELL | 3455 WHITE BEECH LANE YOUNGSTOWN, OH 44511 | AFLAC | $1K | $40 | $1K | 3.37% |
| RANDY L JONES3 | 4741 MAHONING AVENUE NORTHWEST WARREN, OH 44483 | AFLAC | $1K | — | $1K | 3.18% |
| GAYLORD I KAUFFMAN3 Filed as: GAYLORD KAUFFMAN | 315 GREEN RIDGE ROAD SUITE H1 NEW CASTLE, PA 16105 | AFLAC | $509 | — | $509 | 1.50% |
| JULIE COLLINGWOOD3 Filed as: JULIE M COLLINGWOOD | 92 WALTON AVENUE STRUTHERS, OH 44471 | AFLAC | $332 | — | $332 | 0.98% |
| LEON KOKAL3 | 10478 TOLLAND DRIVE AURORA, OH 44202 | AFLAC | $257 | $8 | $265 | 0.78% |
| BRADLEY MELVIN3 Filed as: BRADLEY D MELVIN | 2895 WEST CALLA ROAD CANIFIELD, OH 44406 | AFLAC | $160 | — | $160 | 0.47% |
| GREGORY D. HOVANIC3 Filed as: GREGORY D HOVANIC | 5100 BELMONT AVENUE SUITE 5 YOUNGSTOWN, OH 44505 | AFLAC | $145 | — | $145 | 0.43% |
| LEWIS P AGNONE3 | 360 EASTWOOD DRIVE HUBBARD, OH 44425 | AFLAC | $101 | $8 | $109 | 0.32% |
| GEORGE C MALINKY3 | 7000 NEW ROAD YOUNGSTOWN, OH 44515 | AFLAC | $99 | — | $99 | 0.29% |
| BRIAN TODD KAUFFMAN3 | 315 GREEN RIDGE ROAD SUITE H-1 NEW CASTLE, PA 16105 | AFLAC | $95 | — | $95 | 0.28% |
| PAMELA L CURRAN3 | 435 AFTON AVENUE YOUNGSTOWN, OH 44512 | AFLAC | $92 | — | $92 | 0.27% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INS AGENCY INC | 9404 WOODCHIP LANE BROADVIEW HEIGHTS, OH 44147 | AFLAC | $89 | — | $89 | 0.26% |
| MICHAEL D EVANS JR3 | 3199 SIOUX CONIFER ROAD WATERTOWN, SD 57201 | AFLAC | $69 | — | $69 | 0.20% |
| THOMAS J HOUSER3 | 2720 BRIARWOOD COURT POLAND, OH 44514 | AFLAC | $68 | — | $68 | 0.20% |
| DOUGLAS P MCMULLIN3 | 131 FRANKLIN STREEET SAINT CLAIRSVILLE, OH 43950 | AFLAC | $55 | — | $55 | 0.16% |
| CHARLES V KOUNTZ3 | 310 CRIMSON CIRCLE CAMPBELL, OH 44405 | AFLAC | $42 | — | $42 | 0.12% |
| MICHAEL J QUINN3 | 8580 MAJORCA LANE NAPLES, FL 34114 | AFLAC | $38 | — | $38 | 0.11% |
| HARE AND ASSOCIATES LLC3 | 470 OLDE WORTHINTON SUITE 250 WESTERVILL, OH 43082 | AFLAC | $16 | $8 | $24 | 0.07% |
| DAVID P AESOPH3 | 1301 SOUTH SUMMIT AVENUE SIOUX FALLS, SD 57105 | AFLAC | $16 | — | $16 | 0.05% |
| QUINN, MEYER & ASSOCIATES3 | 10800 WINCHCOMBRE DRIVE DUBLIN, CA 43016 | AFLAC | $13 | — | $13 | 0.04% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 142 | $1.3M |
| Dental | COMMUNITY INSURANCE COMPANY | 161 | $98K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 174 | $47K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 174 | $47K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 174 | $47K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 174 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.