| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $885 | $4K | $5K | 10.20% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.30% |
| SAVAGE & ASSOCIATES INC3 | 655 BEAVER CREEK CIRCLE MAUMEE, OH 43537 | DELTA DENTAL OF OHIO | $4K | — | $4K | 9.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 E CARMEL DR STE 400 CARMEL, IN 46032 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.59% |
| JACOB COX3 | 140 LANE 100 LONG LAKE FREEMONT, IN 46737 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $701 | — | $701 | 2.23% |
| SAVAGE & ASSOCIATES INC3 | 655 BEAVER CREEK CIRCLE MAUMEE, OH 43537 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $92 | — | $92 | 0.29% |
| JOSEPH E TROIANO3 | 2854 LYTLE RD CENTERBURG, OH 43011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $86 | $0 | $86 | 0.27% |
| GREGORY P HOLLERN3 | 400 CARDINAL HILL LANE POWELL, OH 43065 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $57 | — | $57 | 0.18% |
| SHAWN MOSSELEY3 | 3700 SHAGBARK GALENA, OH 43201 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $56 | $0 | $56 | 0.18% |
| JACK L SHORT3 | 176 PATTI DR WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $39 | — | $39 | 0.12% |
| GARY MOSELEY3 Filed as: GARY L MOSSELEY | 1790 TOWNSHIP RD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33 | — | $33 | 0.11% |
| GAYLE A. DENNIS3 | 1760 TOWNSHIP RD 55 BELFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | — | $26 | 0.08% |
| BRAD MESZAROS3 | 50 OLD VILLAGE RD STE 213 COLUMBUS, OH 43228 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| DENNIS N SHAY3 Filed as: DENNIS SHAY | 409 MANILLA PLACE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| GALLAGEHER BENEFIT SERVICES, INC.3 Filed as: GALLAGEHER BENEFIT SERVICES INC. | 650 E CARMEL DR STE 400 CARMEL, IN 46031 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $347 | $2K | $2K | 9.97% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.30% |
| ARIS GROUP LLC3 | 7862 KINGLAND DR. STE 100 WEST CHESTER, OH 43570 | ASSURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 73.29% |
| JULIE OXENDER3 Filed as: JULIE ANN OXENDER | PO BOX 464 10462 SR 191 WEST UNITY, OH 43570 | ASSURITY LIFE INSURANCE COMPANY | $884 | — | $884 | 32.17% |
| SAVAGE & ASSOCIATES INC3 | 655 BEAVER CREEK CIRCLE MAUMEE, OH 43537 | ASSURITY LIFE INSURANCE COMPANY | $581 | — | $581 | 21.14% |
| 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 | $42 | $215 | $257 | 10.48% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $204 | $0 | $204 | 8.32% |
| 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 | $20 | $101 | $121 | 10.22% |
| MONTANA HEALTH NETWORK DBA FRINGE3 | 393 W. GORDON AVE STE 1 LAYTON, UT 84041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $98 | $0 | $98 | 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 | 397 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 397 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | DELTA DENTAL OF OHIO | 664 | $39K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 270 | $55K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 143 | $31K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 269 | $20K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 271 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 664 | — |
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.