| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRENDA K COX3 Filed as: BRENDA K. COX | 3604 NORTH GRAND AVENUE CONNERSVILLE, IN 47331 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17K | $3K | $21K | 15.71% |
| RACHEL SUZANNE WILLOUGHBY3 | 6381 CLOUGH PIKE, APARTMENT 3 CINCINNATI, OH 45244 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 4.11% |
| MJ INSURANCE3 Filed as: SHIRLEY ISAACS AND VARIOUS AGENTS | 5196 SOUTH COUNTRY ROAD 450 EAST CONNERSVILLE, IN 47331 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $384 | $3K | 2.03% |
| VALLERY SWARTZ-HOY3 | 6222 MARYHURST DRIVE DUBLIN, OH 43017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $139 | $2K | 1.72% |
| JUSTIN J MCDONALD3 Filed as: JUSTIN J. MCDONALD | 12052 PEPPERMILL LANE PICKERINGTON, OH 43147 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $279 | $2K | 1.55% |
| JOSEPH MCDONALD3 | 12052 PEPPERMILL LANE NW PICKERINGTON, OH 43147 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $149 | $1K | 0.96% |
| HARRIET M. ARGUE3 | 800 BANBURY ROAD DAYTON, OH 45459 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.78% |
| ASSURED NEACE LUKENS INS. AGENCY3 Filed as: ASSURED NEACE LUKENS | 2305 RIVER ROAD LOUISVILLE, KY 40206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $6K | $20K | 16.04% |
| ASSURED NEACE LUKENS INS. AGENCY3 | 5905 EAST GALBRAITH ROAD CINCINNATI, OH 45236 | VISION SERVICE PLAN | $2K | — | $2K | 4.08% |
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 | 317 | 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) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 227 | $40K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $125K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $125K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 317 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.