| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOREST S STARR3 Filed as: FOREST STARR JR | 111 W ERIE ST JEFFERSON, OH 44047 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $3K | — | $3K | 7.71% |
| FOREST S STARR3 Filed as: FOREST STARR SR | 2228 CHAPEL RD JEFFERSON, OH 44047 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1K | — | $1K | 2.24% |
| LINDA STARR3 | 2228 CHAPEL RD JEFFERSON, OH 44047 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $708 | $42 | $750 | 1.68% |
| CHARLES HOWARD JOBE3 Filed as: CHARLES JOBE | 8421 EVERGREEN DR NORTHFIELD, OH 44067 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $559 | $48 | $607 | 1.36% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INSURANCE AGENCY | 9404 WOODCHIP LN BROADVIEW HTS, OH 44147 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $451 | $48 | $499 | 1.12% |
| STEPHEN BRIAN LOMBARDOZZI3 Filed as: STEPHEN LOMBARDOZZI | 5329 GARGASZ DR LORAIN, OH 44053 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $284 | — | $284 | 0.64% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY ATLANTA, GA 30339 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $202 | — | $202 | 0.45% |
| RICO PEREZ3 | 6000 LOMBARDO CIR SEVEN HILLS, OH 44131 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $143 | — | $143 | 0.32% |
| JOSEPH MANGANO3 | 6100 OAK TREE BLVD INDEPENDENCE, OH 44131 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $94 | — | $94 | 0.21% |
| CHERYL C PEREZ3 Filed as: CHERYL PEREZ | 5755 GRANGER RD INDEPENDENCE, OH 44131 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $86 | — | $86 | 0.19% |
| TIMOTHY R QUINLAN3 Filed as: TIMOTHY QUINLAN | PO BOX 387 CONNOQUESESSING, PA 16027 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $73 | — | $73 | 0.16% |
| S SCOTT HUMPHREY3 | 5908 RUSSIA RD AMHERST, OH 44001 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $37 | — | $37 | 0.08% |
| MARK METTILLE3 Filed as: MARK WHEELER | 773 SANDUSKY STREET CONNEAUT, OH 44030 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $30 | — | $30 | 0.07% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL EVANS SR | 3199 SIOUX CONIFER RD WATERTOWN, SD 57201 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $22 | — | $22 | 0.05% |
| RICHARD MAKOWSKI3 | 4712 E 90TH ST GARFIELD HTS, OH 44125 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $18 | — | $18 | 0.04% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $18 | — | $18 | 0.04% |
| QUINN, MEYER & ASSOCIATES3 Filed as: QUINN MEYER AND ASSOC | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $15 | — | $15 | 0.03% |
| BRADLEY MELVIN3 | 2895 W CALLA DR CANFIELD, OH 44406 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $15 | — | $15 | 0.03% |
| LEON KOKAL3 | 10478 TOLLAND DR AURORA, OH 44202 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $14 | — | $14 | 0.03% |
| BRIAN TODD KAUFFMAN3 Filed as: BRIAN KAUFFMAN | 3009 WILMINGTON RD NEW CASTLE, PA 16105 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $12 | — | $12 | 0.03% |
| ROBERTA DICKINSON3 | PO BOX 360559 STRONGSVILLE, OH 44136 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $11 | — | $11 | 0.02% |
| OPPORTUNITY INC3 | 9404 WOODCHIP LN BROADVIEW HTS, OH 44147 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $10 | — | $10 | 0.02% |
| GREG MINTZ3 | 3319 ERIN AVE CLEVELAND, OH 44113 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $7 | — | $7 | 0.02% |
| HARE AND ASSOCIATES LLC3 Filed as: HARE AND ASSOC LLC | 6324 TARTON FIELDS LN MASON, OH 45040 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $6 | — | $6 | 0.01% |
| JOHN C RASCHELLA3 Filed as: JOHN RASCHELLA | 20521 TAHITIAN BLVD ESTERO, FL 33928 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $2 | — | $2 | 0.00% |
| RONALD J GRETHEL3 Filed as: RONALD GRETHEL | 648 HANNA AVE LOVELAND, OH 45140 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $2 | — | $2 | 0.00% |
| JACK A SHADE3 Filed as: JACK SHADE | 690 TREE BEND CT WESTERVILLE, OH 43082 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $2 | — | $2 | 0.00% |
| KARA M CARMODY3 Filed as: KARA CARMODY | 718 HOYT AVE E ST PAUL, SD 57054 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1 | — | $1 | 0.00% |
| RPM LTD3 | PO BOX 1016 YULEE, FL 32041 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1 | — | $1 | 0.00% |
| JOHN D SUSIE3 Filed as: JOHN SUSIE | 8682 HAWICK CT N DUBLIN, OH 43017 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1 | — | $1 | 0.00% |
| REDTAIL LTD3 | 9999 BREWSTER LANE STE 100 POWELL, OH 43065 | MEDMUTUAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.39% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | 73 | $45K |
| Life insurance | MEDMUTUAL LIFE INSURANCE COMPANY | 109 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.