| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1100 SUPERIOR AVENUE SUITE 1700 CLEVELAND, OH 44114 | MEDICAL MUTUAL OF OHIO | $31K | $16K | $47K | 4.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1100 SUPERIOR AVE EAST SUITE 1700 CLEVELAND, OH 44114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $3K | $15K | 12.09% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BENEFITS INC | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE | $506 | — | $506 | 3.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 601 NW LOOP 410 SUITE 325 SAN ANTONIO, TX 78216 | AMERICAN HERITAGE LIFE INSURANCE | $297 | — | $297 | 2.21% |
| PATRICIA J REDIC3 | 46 CHAGRIN PLAZA SUITE 103 CHAGRIN FALLS, OH 44022 | AMERICAN HERITAGE LIFE INSURANCE | $217 | — | $217 | 1.61% |
| CGI GROUP BENEFITS3 Filed as: CGI GROUP BENEFITS SERVICES INC | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE | $200 | — | $200 | 1.48% |
| BAYSIDE BFT SOLUTIONS LLC3 Filed as: BAYSIDE BENEFIT SOLUTION LLC | 309 FOREST BREEZE AVE BRANDON, FL 33511 | AMERICAN HERITAGE LIFE INSURANCE | $44 | — | $44 | 0.33% |
| JOSEPH GORTZ3 | 5574 BARNEY DR DUBLIN, OH 43016 | AMERICAN HERITAGE LIFE INSURANCE | $41 | — | $41 | 0.30% |
| JAMES DOMINIC FERNANDEZ3 | 4427 MAPLEPARK ROAD STOW, OH 44224 | AMERICAN HERITAGE LIFE INSURANCE | $36 | — | $36 | 0.27% |
| THOMAS W BOSTON3 Filed as: THOMAS W. BOSTON | 1275 WEST MAPLE STREET HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE | $8 | — | $8 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 1111 SUPERIOR AVENUE SUITE 1610 CLEVELAND, OH 44114 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.96% |
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 | 233 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 163 | $1.1M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $127K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 132 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $127K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $127K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $127K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 163 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.