| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $149 | $4K | 5.29% |
| RH BUIE INSURANCE AGENCY INC3 | 3260 VAN AKEN BLVD SHAKER HEIGHTS, OH 44120 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.76% |
| PATRICIA HERTZOG3 | 8825 CHAUCER BLVD BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $111 | $2K | 1.97% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44310 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $38 | $1K | 1.27% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M IGNASIAK | 8427 MUIRLAND DRIVE CLEVELAND, OH 44147 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $731 | $33 | $764 | 0.90% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH A WILLHITE | 3619 1/2 PONCIANA AVENUE AKRON, OH 44319 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $742 | $14 | $756 | 0.89% |
| VALENE M WOLFE3 Filed as: VALENE M WOLF | 1265 CIRCLE DRIVE AKRON, OH 44310 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.06% |
| SUSAN ELIZABETH HARDY3 | 7245 WILLOW WAY NORTH OLMSTED, OH 44070 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.03% |
| DAVID L SMELCER3 Filed as: DAVID A SMELCER | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| RH BUIE INSURANCE AGENCY INC3 | 3260 VAN AKEN BLVD SHAKER HEIGHTS, OH 44120 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.70% |
| RH BUIE INSURANCE AGENCY INC3 | 3260 VAN AKEN BLVD SHAKER HEIGHTS, OH 44120 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP MANAGEMENT SERVICES INC EIN 34-1707723 TPA | Contract Administrator Service code 13 | — | $71K |
| RH BUIE INSURANCE EIN 46-5092469 BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $35K |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNDERWRITING MANAGEMENT EXPERTS GERBER LIFE | 108 | $292K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $58K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 103 | $10K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 69 | $85K |
| Stop-loss / reinsurancereinsurance | UNDERWRITING MANAGEMENT EXPERTS GERBER LIFE | 108 | $292K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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."
No prospect flags tripped on this filing.