| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF THE MIDWES | PO BOX 700 DEFIANCE, OH 43512 | DELTA DENTAL OF OHIO | $3K | — | $3K | 0.99% |
| INSGROUP INC3 Filed as: FIRST INS GROUP OF THE MIDWEST INC | PO BOX 700 DEFIANCE, OH 43512 | HARTFORD LIFE AND ACCIDENT | $31K | $1K | $32K | 15.49% |
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP | 1650 NORTH COUNTY LINE STREET SUITE 200 FOSTORIA, OH 44830 | VISION SERVICE PLAN | $3K | — | $3K | 2.47% |
| KEELER & ASSOCIATES3 | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 7.38% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 4.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 650 EAST CARMEL DRIVE SUITE 350 CARMEL, IN 46032 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 1.61% |
| MOSELEY NICOLE3 | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $334 | — | $334 | 0.34% |
| GORDON JESSICA3 | 2955 SYCAMORE LANE BLOOMSBURG, PA 17815 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $294 | — | $294 | 0.30% |
| TROIANO JOSEPH E3 | 2854 LYTLE ROAD CENTERBURG, OH 43011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $293 | — | $293 | 0.30% |
| DENNIS GAYLE3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $262 | — | $262 | 0.27% |
| MOSELEY GARY L3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $128 | — | $128 | 0.13% |
| MOSELEY NICOLE3 Filed as: MOSELEY SHAWN L | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $64 | — | $64 | 0.07% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $46 | — | $46 | 0.05% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| MACK FRANK TIMOTHY3 | 3125 TIGER RUN COURT SUITE 105 CARLSBAD, CA 92010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | -$1 | — | -$1 | -0.00% |
| KEELER & ASSOCIATES3 | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 7.60% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 1.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 650 EAST CARMEL DRIVE SUITE 350 CARMEL, IN 46032 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $626 | — | $626 | 0.65% |
| MOSELEY NICOLE3 | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $122 | — | $122 | 0.13% |
| TROIANO JOSEPH E3 | 2854 LYTLE ROAD CENTERBURG, OH 43011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $108 | — | $108 | 0.11% |
| GORDON JESSICA3 | 2955 SYCAMORE LANE BLOOMSBURG, PA 17815 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $107 | — | $107 | 0.11% |
| DENNIS GAYLE3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINEE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $95 | — | $95 | 0.10% |
| MOSELEY GARY L3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $52 | — | $52 | 0.05% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $35 | — | $35 | 0.04% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $35 | — | $35 | 0.04% |
| MOSELEY NICOLE3 Filed as: MOSELEY SHAWN L | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | — | $26 | 0.03% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | — | $20 | 0.02% |
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 | 829 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 855 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 1,005 | $347K |
| Vision | VISION SERVICE PLAN | 438 | $111K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 675 | $301K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 675 | $204K |
| Stop-loss / reinsurancereinsurance | SWISS RE | 488 | $451K |
| Other(4 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 857 | $409K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,005 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.