| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 4.53% |
| FINDLEY DAVIES AGENCY, LLC3 Filed as: FINDLEY DAVIES, LLC | ONE SEAGATE STE 2050 TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 1.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 40948 INDIANAPOLIS, IN 462400948 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $7K | — | $7K | 12.11% |
| DENNIS N SHAY3 Filed as: DENNIS SHAY | 409 MANILA PLACE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $671 | — | $671 | 1.15% |
| JOSEPH E TROIANO3 | 1242 CANDORA STREET BLACKLICK, OH 43004 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $607 | — | $607 | 1.04% |
| SHAWN MOSELEY3 | 4972 SOFTWOOD COURT WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $355 | — | $355 | 0.61% |
| GAYLE A. DENNIS3 Filed as: GAYLE A DENNIS | 142 PAINE STREET DELAWARE, OH 43015 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $227 | — | $227 | 0.39% |
| GARY MOSELEY3 Filed as: GARY L MOSELEY | 7415 PORT ROYALE AVENUE RUSSELLS POINT, OH 43348 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $211 | — | $211 | 0.36% |
| JACK L SHORT3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $208 | — | $208 | 0.36% |
| DORIS A. BOWLING3 Filed as: DORIS A BOWLING | 693 STATE ROUTE 314 MANSFIELD, OH 43081 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $159 | — | $159 | 0.27% |
| BRAD MESZAROS3 | 50 OLD VILLAGE RD., SUITE 213 COLUMBUS, OH 43228 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $84 | — | $84 | 0.14% |
| GREGORY P HOLLERN3 | 400 CARDINAL HILL LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | $16 | — | $16 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC. | SUITE 400 650 E. CARMEL DR. CARMEL, IN 46032 | PRE-PAID LEGAL SERVICES, INC. D/B/A LEGALSHIELD | $572 | — | $572 | 12.62% |
| VICKI L. SHIPP4 | SUITE E 610 PROFESSIONAL PARK DR. NEW HAVEN, IN 46774 | PRE-PAID LEGAL SERVICES, INC. D/B/A LEGALSHIELD | $158 | — | $158 | 3.49% |
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 | 419 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 421 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE D/B/A ALLSTATE BENEFITS | 154 | $58K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 291 | $63K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 291 | $63K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE D/B/A AIG BENEFIT SOLUTIONS | 295 | $296K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 291 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.