| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: FIRST INS GROUP OF THE MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 12.17% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 5.18% |
| INSGROUP INC3 Filed as: FIRST INS GROUP OF THE MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $880 | — | $880 | 3.26% |
| KESNER INS AGCY INC3 | 2522 WENDELL AVENUE LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $81 | — | $81 | 0.30% |
| TERRY REICHENBACH3 | P. O. BOX 178 PANDORA, OH 45877 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $68 | — | $68 | 0.25% |
| WORKPLACE EMPLOYEE BNFT SVCS3 | 1240 WEST MARKET STREET, SUITE 3 LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33 | — | $33 | 0.12% |
| HUFFMAN JEFFREY3 | 711 PLAZA DRIVE, SUITE 1 CHESTERTON, IA 46304 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $17 | — | $17 | 0.06% |
| ADVANTAGE GROUP GA LLC3 Filed as: ADVANTAGE GROUP MGA, LLC | 7862 KINGLAND DRIVE SUITE 100 WEST CHESTER, OH 45069 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.04% |
| ARIS GROUP LLC3 Filed as: ARIS GROUP | — | ASSURITY LIFE INSURANCE COMPANY | $487 | — | $487 | 4.24% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | — | ASSURITY LIFE INSURANCE COMPANY | $378 | — | $378 | 3.29% |
| TINA M THOMPSON DENNIS3 Filed as: TINA MARIE THOMPSON DENNIS | — | ASSURITY LIFE INSURANCE COMPANY | $239 | — | $239 | 2.08% |
| KRISTEN D PRESTON3 Filed as: KRISTEN DEEANNA PRESTON | — | ASSURITY LIFE INSURANCE COMPANY | $157 | — | $157 | 1.37% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE INC | PO BOX 736061 CHICAGO, IL 60673 | PRINCIPAL LIFE INSURANCE COMPANY | $544 | — | $544 | 6.43% |
| RSC INSURANCE BROKERAGE INC3 | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | — | $254 | $254 | 3.00% |
| FIRST INSURANCE GRP OF THE MIDWEST3 | 511 5TH STREET DEFIANCE, OH 43512 | PRINCIPAL LIFE INSURANCE COMPANY | $54 | — | $54 | 0.64% |
| ARIS GROUP LLC3 Filed as: ARIS GROUP, LLC | 7862 KINGLAND DRIVE WEST CHESTER, OH 45069 | TRANSAMERICA LIFE INSURANCE COMPANY | $85 | — | $85 | 6.04% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE INC | 160 FEDERAL STREET, FL 4 BOSTON, MA 02110 | TRANSAMERICA LIFE INSURANCE COMPANY | $57 | — | $57 | 4.05% |
| TINA M THOMPSON DENNIS3 Filed as: TINA THOMPSON DENNIS | 205 EDEN'S OAKS COURT SIX MILE, SC 29682 | TRANSAMERICA LIFE INSURANCE COMPANY | $25 | — | $25 | 1.78% |
| KRISTEN D PRESTON3 Filed as: KRISTEN PRESTON | 6745 COUNTY ROAD 45 ALGER, OH 45812 | TRANSAMERICA LIFE INSURANCE COMPANY | $13 | — | $13 | 0.92% |
| VBW INSURANCE SERVICES, INC3 | 2121 NEWMARKET PARKWAY, SUITE 100 MARIETTA, GA 30067 | TRANSAMERICA LIFE INSURANCE COMPANY | $8 | — | $8 | 0.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE EMPLOYEE BENEFIT SERVICE CENTER EIN 55-0713888 ADMINISTRATOR | Claims processing Service code 12 | 4430 KANAWHA TURNPIKE SOUTH CHARLESTON, WV 25309 | $36K |
| FIRST INSURANCE GROUP EIN 34-0940616 BROKER | Insurance agents and brokers Service code 22 | 2600 ALLENTOWN ROAD LIMA, OH 45805 | $23K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 PPO NETWORK | Other fees Service code 99 | PO BOX 632328 CINCINNATI, OH 45263 | $15K |
| QUALITY CARE PARTNERS EIN 31-1435470 CASE MANAGEMENT | Other fees Service code 99 | 2806 BELL STREET ZANESVILLE, OH 43701 | $7K |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 157 | $8K |
| Life insurance(4 contracts, 4 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 122 | $116K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 122 | $61K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 122 | $61K |
| Other(5 contracts, 5 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 122 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.