| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 650 E CARMEL DR SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $5K | $6K | 10.16% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.30% |
| SAVAGE & ASSOCIATES INC3 | 655 BEAVER CREEK CIRCLE MAUMEE, OH 43537 | VISION SERVICE PLAN | $3K | $0 | $3K | 6.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 650 E CARMEL DR STE 400 CARMEL, IN 46032 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.76% |
| JACOB COX3 | 140 LANE 100 LONG LAKE FREEMONT, IN 46737 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.44% |
| SAVAGE & ASSOCIATES INC3 | 655 BEAVER CREEK CIRCLE MAUMEE, OH 43537 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $142 | — | $142 | 0.33% |
| JOSEPH E TROIANO3 | 2854 LYTLE RD CENTERBURG, OH 43011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $122 | $0 | $122 | 0.28% |
| SHAWN L MOSELEY3 Filed as: SHAWN L. MOSSELEY | 3700 SHAGBARK GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $76 | — | $76 | 0.18% |
| GREGORY P HOLLERN3 | 400 CARDINAL HILL LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $70 | $0 | $70 | 0.16% |
| JACK L SHORT3 Filed as: JACK L. SHORT | 176 PATTI DR WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $62 | $0 | $62 | 0.14% |
| GAYLE A. DENNIS3 | 1760 TOWNSHIP RD 55 BELFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $54 | $0 | $54 | 0.13% |
| GARY MOSELEY3 Filed as: GARY L MOSSELEY | 1790 TOWNSHIP RD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $52 | $0 | $52 | 0.12% |
| DENNIS N SHAY3 Filed as: DENNIS SHAY | 409 MANILA PLACE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| BRAD MESZAROS3 | 50 OLD VILLAGE RD STE 213 COLUMBUS, OH 43228 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 650 E CARMEL DR STE 400 CARMEL, IN 46031 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $377 | $2K | $2K | 10.00% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 650 E CARMEL DR STE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $52 | $258 | $310 | 10.13% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $254 | $0 | $254 | 8.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 650 E CARMEL DR STE 400 CARMEL, IL 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $24 | $120 | $144 | 10.28% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $116 | $0 | $116 | 8.28% |
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 | 407 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 259 | $48K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 283 | $61K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 143 | $43K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 277 | $22K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 283 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.