| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP | 511 FIFTH STREET DEFIANCE, OH 43512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 12.69% |
| ADVANTAGE GROUP OHIO LLC3 Filed as: ADVANTAGE GROUP-OHIO, LLC | 3848 CHERRY BROOKE LANE MASON, OH 45040 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $69 | — | $69 | 0.42% |
| KESNER INS AGCY INC3 Filed as: KESNER INSURANCE AGENCY, INC. | 2522 WENDELL AVENUE LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $55 | — | $55 | 0.34% |
| RON HALLER3 | 331 KLINGLER ROAD PAULDING, OH 45879 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $25 | — | $25 | 0.15% |
| TERRY REICHENBACH3 | P. O. BOX 178 PANDORA, OH 45877 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | — | $24 | 0.15% |
| WORKPLACE EMPLOYEE BNFT SVCS3 Filed as: WORKPLACE EMPLOYEE BENEFIT SERVICES | 1240 W. MARKET STREET, #3 LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP | 511 FIFTH STREET DEFIANCE, OH 43512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 12.80% |
| TERRY REICHENBACH3 | P. O. BOX 178 PANDORA, OH 45877 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $93 | — | $93 | 0.60% |
| RON HALLER3 | 331 KLINGLER ROAD PAULDING, OH 45879 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $83 | — | $83 | 0.54% |
| ADVANAGE GROUP-OHIO, LLC3 | 3848 CHERRY BROOKE LANE MASON, OH 45040 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $76 | — | $76 | 0.49% |
| KESNER INS AGCY INC3 Filed as: KESNER INSURANCE AGENCY | 2522 WENDELL AVENUE LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $55 | — | $55 | 0.36% |
| JOHN O'CONNOR3 | 3087 W. ALLENTOWN ROAD LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.10% |
| WORKPLACE EMPLOYEE BNFT SVCS3 Filed as: WORKPLACE EMPLOYEE BENEFIT SERVICES | 1240 W. MARKET STREET, #3 LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| RON L HALLER3 Filed as: RON L. HALLER | 1240 W. MARKET STREET LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP | 511 FIFTH STREET DEFIANCE, OH 43512 | DEARBORN LIFE INSURANCE COMPANY | $8K | — | $8K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE EMPLOYEE BENEFIT SERVICE EIN 55-0713888 ADMINIATRATOR | Claims processing Service code 12 | 4430 KANAWHA TURNPIKE SOUTH CHARLETON, WV 25309 | $32K |
| FIRST INSURANCE GROUP EIN 34-0940616 BROKER | Insurance agents and brokers Service code 22 | 2600 ALLENTOWN ROAD LIMA, OH 45805 | $21K |
| HCC LIFE INURANCE COMPANY EIN 34-0648820 BROKER | Insurance agents and brokers Service code 22 | P. O. BOX 842173 LOS ANGELES, CA 900842173 | $18K |
| MEDICAL MUTUAL OF OHIO EIN 76-0572393 PPO NETWORK | Other fees Service code 99 | P. O. BOX 632328 CINCINNATI, OH 452632328 | $17K |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 163 | $25K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 130 | $0 |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 163 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.