| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAG3 | TWO PIERCE PLACE ITASCA, IL 60143 | COMMUNITY INSURANCE COMPANY | $17K | — | $17K | 1.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 8TH FLOOR ROLLING MEADOWS, IL 60008 | COMMUNITY INSURANCE COMPANY | $11K | $3K | $14K | 0.93% |
| THE JAMES B OSWALD COMPANY3 | 1360 EAST 9TH STREET #600 CLEVELAND, OH 44114 | COMMUNITY INSURANCE COMPANY | $3K | $3K | $6K | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 60143 | ANTHEM LIFE INSURANCE COMPANY | $3K | $2K | $4K | 4.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 8TH FLOOR ROLLING MEADOWS, IL 60008 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 3.35% |
| THE JAMES B OSWALD COMPANY3 | 1360 EAST 9TH STREET #600 CLEVELAND, OH 44114 | ANTHEM LIFE INSURANCE COMPANY | $571 | — | $571 | 0.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8561 EAST AVENUE MENTOR, OH 44060 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 8.23% |
| LEWIS P AGNONE3 | 360 EASTWOOD DRIVE HUBBARD, OH 44425 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.86% |
| COREY J JONES3 | 2400 HENN HYDE ROAD NORTHEAST WARREN, OH 44484 | CONTINENTAL AMERICAN INSURANCE COMPANY | $696 | — | $696 | 1.77% |
| MELISSA ANN GREENE-SHULTZ3 Filed as: MELISSA A GREENE SHULTZ | 6731 LINCOLN AVENUE HUBBARD, OH 44425 | CONTINENTAL AMERICAN INSURANCE COMPANY | $540 | — | $540 | 1.37% |
| CHRISTOPHER KOSCHACK3 | 47597 BELL SCHOOL ROAD EAST LIVERPOOL, OH 43920 | CONTINENTAL AMERICAN INSURANCE COMPANY | $426 | — | $426 | 1.08% |
| THOMAS J HOUSER3 | 955 WINHAM COURT SUITE 4 BOARDMAN, OH 44512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $353 | — | $353 | 0.90% |
| MICHAEL ROBERT YURCZYK3 Filed as: MICHAEL R YURCZYK | 5810 WEST 78TH STREET SUITE 210 BLOOMINGTON, MN 55439 | CONTINENTAL AMERICAN INSURANCE COMPANY | $286 | — | $286 | 0.73% |
| BOR HOUSE ACCOUNT3 | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $251 | — | $251 | 0.64% |
| PAUL D QUILLIN3 | 955 WINDHAM COURT YOUNGSTOWN, OH 44512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $177 | — | $177 | 0.45% |
| AMDREW F VERBOSKY JR3 Filed as: AMDREW F VERBOSKY, JR. | 491 QUARRY LANE WARREN, OH 44483 | CONTINENTAL AMERICAN INSURANCE COMPANY | $128 | — | $128 | 0.33% |
| JV FLORIDA INSURANCE CORP3 Filed as: JV FLORIDA INSUARNCECORP | 2821 NORTH OCEAN BOULEVARD #305 FT LAUDERDALE, FL 33308 | CONTINENTAL AMERICAN INSURANCE COMPANY | $89 | — | $89 | 0.23% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 169 | $1.5M |
| Dental | ANTHEM LIFE INSURANCE COMPANY | 170 | $95K |
| Vision | COMMUNITY INSURANCE COMPANY | 169 | $1.5M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 170 | $95K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 170 | $95K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 170 | $95K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 170 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
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.