| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOREST S STARR3 Filed as: FOREST SAMUEL STARR JR | 111 W ERIE ST JEFFERSON, OH 44047 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $8K | — | $8K | 14.89% |
| LINDA STARR3 | 2228 CHAPEL RD JEFFERSON, OH 44047 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1K | $49 | $1K | 2.26% |
| WILLIAM JAY MOTHERSBAUGH3 Filed as: WILLIAM MOTHERSBAUGH | 13705 PINEY HOLLOW LANE PAINESVILLE, OH 44077 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $921 | $53 | $974 | 1.71% |
| CHARLES HOWARD JOBE3 Filed as: CHARLES JOBE | 8421 EVERGREEN DR NORTHFIELD, OH 44067 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $744 | $56 | $800 | 1.40% |
| STEPHEN BRIAN LOMBARDOZZI3 Filed as: STEPHEN LOMBARDOZZI | 5329 GARGASZ DR LORAIN, OH 44053 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $792 | — | $792 | 1.39% |
| FOREST S STARR3 Filed as: FOREST SAMUEL STARR SR | 2228 CHAPEL RD JEFFERSON, OH 44047 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $684 | — | $684 | 1.20% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $343 | — | $343 | 0.60% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INSURANCE AGENCY | 9494 WOODCHIP LN BROADVIEW HTS, OH 44147 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $237 | $4 | $241 | 0.42% |
| RICO PEREZ3 | 6000 LOMBARDO CIRCLE SEVEN HILLS, OH 44131 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $118 | — | $118 | 0.21% |
| JOSEPH MANGANO3 | 6100 OAK TREE BLVD INDEPENDENCE, OH 44131 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $88 | — | $88 | 0.15% |
| CHERYL C PEREZ3 Filed as: CHERYL PEREZ | 5755 GRANGER RD INDEPENDENCE, OH 44131 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $69 | — | $69 | 0.12% |
| TIMOTHY R QUINLAN3 Filed as: TIMOTHY QUINLAN | PO BOX 387 CONNOQUENESSING, PA 16027 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $47 | — | $47 | 0.08% |
| S SCOTT HUMPHREY3 | 5908 RUSSIA ROAD AMHERST, OH 44001 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $37 | — | $37 | 0.06% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL EVANS JR | 3199 SIOUX CONIFER RD WATERTOWN, SD 57201 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $22 | — | $22 | 0.04% |
| MARK METTILLE3 Filed as: MARK WHEELER | 773 SANDUSKY ST CONNEAUT, OH 44030 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $19 | — | $19 | 0.03% |
| DAVID P AESOPH3 Filed as: DAVID AESOLPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $18 | — | $18 | 0.03% |
| RICHARD MAKOWSKI3 | 4712 E 90TH ST GARFIELD HTS, OH 44125 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $12 | — | $12 | 0.02% |
| QUINN, MEYER & ASSOCIATES3 Filed as: QUINN MEYER AND ASSOC | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $10 | — | $10 | 0.02% |
| ROBERTA DICKINSON3 | PO BOX 360559 STRONGSVILLE, OH 44136 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $8 | — | $8 | 0.01% |
| BRIAN TODD KAUFFMAN3 Filed as: BRIAN KAUFFMAN | 3009 WILMINGTON RD NEW CASTLE, PA 16105 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $7 | — | $7 | 0.01% |
| OPPORTUNITY INC3 | 9494 WOODCHIP LN BROADVIEW HTS, OH 44147 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $7 | — | $7 | 0.01% |
| HARE AND ASSOCIATES LLC3 Filed as: HARE AND ASSOC | 6324 TARTON FIELDS LN MASON, OH 45040 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $6 | — | $6 | 0.01% |
| GREG MINTZ3 | 3319 ERIN AVE CLEVELAND, OH 44113 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $5 | — | $5 | 0.01% |
| JACK A SHADE3 Filed as: JACK SHADE | 1878 VERDICT RIDGE DR DENVER, NC 28037 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $2 | — | $2 | 0.00% |
| JOHN C RASCHELLA3 Filed as: JOHN RASCHELLA | 20521 TAHITIAN BLVD ESTERO, FL 33928 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1 | — | $1 | 0.00% |
| RONALD J GRETHEL3 Filed as: RONALD GRETHEL | 118 HIGHCLIFFE CT LOVELAND, OH 45140 | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | $1 | — | $1 | 0.00% |
| KARA M CARMODY3 Filed as: KARA CARMODY | 718 HOYT AVE E SAINT 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% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVE STE 410 CLEVELAND, OH 44113 | MEDMUTUAL LIFE INSURANCE COMPANY | $607 | — | $607 | 4.93% |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN FAMILY LIFE ASSURANCE CO (AFLAC) | 89 | $57K |
| Life insurance | MEDMUTUAL LIFE INSURANCE COMPANY | 156 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.