| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRITY INSURANCE SOLUTIONS3 | 99 PARK AVENUE WEST SUITE A MANSFIELD, OH 44902 | MEDICAL MUTUAL OF OHIO | $38K | — | $38K | 3.91% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $229 | $2K | 7.73% |
| PATRICIA HERTZOG3 | 8825 CHAUCER BLVD BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $686 | $68 | $754 | 2.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 1100 SUPERIOR AVENUE EAST CLEVELAND, OH 44114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $618 | $14 | $632 | 2.26% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M IGNASIAK | 8427 MUIRLAND DRIVE CLEVELAND, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $362 | $20 | $382 | 1.37% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH A WILLHITE | 3619 1/2 PNICIANA AVENUE AKRON, OH 44319 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $256 | $7 | $263 | 0.94% |
| EDWARD D SOMMER3 Filed as: EDWARD SOMMER | 300 WEST WILSON BRIDGE ROAD WORTHINGTON, OH 43085 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | — | $140 | 0.50% |
| SUZANNE ELIZABETH HARDY3 | 7245 WILLOW WAY NORTH OLMSTED, OH 44070 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.47% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.23% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | ATTENTION BOB RESER LEAWOOD, KS 66211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.11% |
| BST COMPANIES INC3 Filed as: BST COMPANIES | 481 EAST DOWNTOWN STREET TUSCON, AZ 85701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.09% |
| HELEN DIZ-HATTON3 Filed as: HELEN E MCCREADY | 1767 25TH STREET CUYAHOGA FALLS, OH 44223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.08% |
| INTEGRATED EMPLOYEE BENEFIT SOLUTIO3 | 8490 MALLARD COURT PLAIN CITY, OH 43064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.07% |
| DAVID L SMELCER3 | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.04% |
| HOWARD B MESZAROS3 | 8680 COLVIN DRIVE PLAIN CITY, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.04% |
| EC BENEFITS INC3 | 8038 SOUTH 38TH PLACE PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| AMY PARTEE3 | 6665 STONE ROAD MEDINA, OH 44256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 88 | $976K |
| Dental | MEDICAL MUTUAL OF OHIO | 88 | $976K |
| Vision | MEDICAL MUTUAL OF OHIO | 88 | $976K |
| Life insurance | MEDICAL MUTUAL OF OHIO | 88 | $976K |
| Short-term disability | MEDICAL MUTUAL OF OHIO | 88 | $976K |
| Long-term disability | MEDICAL MUTUAL OF OHIO | 88 | $976K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 42 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 88 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.