| 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 | $1K | $9K | 14.37% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 11.32% |
| INSGROUP INC3 Filed as: FIRST INS GROUP OF THE MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 3.49% |
| HUFFMAN JEFFREY3 | 711 PLAZA DRIVE, SUITE 1 CHESTERTON, IA 46304 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $122 | — | $122 | 0.42% |
| KESNER INS AGCY INC3 | 2522 WENDELL AVENUE LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $91 | — | $91 | 0.31% |
| TERRY REICHENBACH3 | P. O. BOX 178 PANDORA, OH 45877 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $80 | — | $80 | 0.27% |
| WORKPLACE EMPLOYEE BNFT SVCS3 | 1240 WEST MARKET STREET, SUITE 3 LIMA, OH 45805 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $43 | — | $43 | 0.15% |
| ADVANTAGE GROUP GA LLC3 Filed as: ADVANTAGE GROUP MGA, LLC | 7862 KINGLAND DRIVE SUITE 100 WEST CHESTER, OH 45069 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | — | $12 | 0.04% |
| ARIS GROUP LLC3 Filed as: ARIS GROUP | — | ASSURITY LIFE INSURANCE COMPANY | $247 | — | $247 | 3.08% |
| INSGROUP INC3 Filed as: FIRST INS GROUP OF HE MIDWEST | 511 FIFTH STREET DEFIANCE, OH 43512 | ASSURITY LIFE INSURANCE COMPANY | $192 | — | $192 | 2.40% |
| TINA M THOMPSON DENNIS3 Filed as: TINA MARIE THOMPSON DENNIS | — | ASSURITY LIFE INSURANCE COMPANY | $121 | — | $121 | 1.51% |
| KRISTEN D PRESTON3 Filed as: KRISTEN DEEANNA PRESTON | — | ASSURITY LIFE INSURANCE COMPANY | $81 | — | $81 | 1.01% |
| FIRST INSURANCE GRP OF THE MIDWEST3 | 511 5TH STREET DEFIANCE, OH 43512 | PRINCIPAL LIFE INSURANCE COMPANY | $441 | — | $441 | 5.67% |
| ARIS GROUP LLC3 Filed as: ARIS GROUP, LLC | 7862 KINGLAND DRIVE WEST CHESTER, OH 45069 | TRANSAMERICA LIFE INSURANCE COMPANY | $74 | — | $74 | 5.71% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE INC | 160 FEDERAL STREET, FL 4 BOSTON, MA 02110 | TRANSAMERICA LIFE INSURANCE COMPANY | $51 | — | $51 | 3.93% |
| TINA M THOMPSON DENNIS3 Filed as: TINA THOMPSON DENNIS | 205 EDEN'S OAKS COURT SIX MILE, SC 29682 | TRANSAMERICA LIFE INSURANCE COMPANY | $23 | — | $23 | 1.77% |
| KRISTEN D PRESTON3 Filed as: KRISTEN PRESTON | 6745 COUNTY ROAD 45 ALGER, OH 45812 | TRANSAMERICA LIFE INSURANCE COMPANY | $12 | — | $12 | 0.93% |
| VBW INSURANCE SERVICES, INC3 | 2121 NEWMARKET PARKWAY, SUITE 100 MARIETTA, GA 30067 | TRANSAMERICA LIFE INSURANCE COMPANY | $9 | — | $9 | 0.69% |
| 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 | $24K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 PPO NETWORK | Other fees Service code 99 | PO BOX 632328 CINCINNATI, OH 45263 | $17K |
| 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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 153 | $8K |
| Life insurance(4 contracts, 4 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 118 | $115K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 118 | $59K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 118 | $59K |
| Other(5 contracts, 5 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 118 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.