| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF THE MIDWES | BEN OTLEY DEFIANCE, OH 43512 | DELTA DENTAL OF OHIO | $11K | — | $11K | 3.25% |
| INSGROUP INC3 Filed as: FIRST INS GROUP OF THE MIDWEST INC | PO BOX 700 DEFIANCE, OH 43512 | HARTFORD LIFE AND ACCIDENT | $32K | — | $32K | 13.89% |
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP | PO BOX 906 FOSTORIA, OH 44830 | VISION SERVICE PLAN | $3K | — | $3K | 2.38% |
| KEELER & ASSOCIATES3 | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 8.91% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 3.76% |
| 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 | $1K | — | $1K | 1.52% |
| MOSELEY NICOLE3 | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $216 | — | $216 | 0.32% |
| GORDON JESSICA3 | 2955 SYCAMORE LANE BLOOMSBURG, PA 17815 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $192 | — | $192 | 0.29% |
| TROIANO JOSEPH E3 | 2854 LYTLE ROAD CENTERBURG, OH 43011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $192 | — | $192 | 0.29% |
| DENNIS GAYLE3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $174 | — | $174 | 0.26% |
| MOSELEY GARY L3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $75 | — | $75 | 0.11% |
| MOSELEY NICOLE3 Filed as: MOSELEY SHAWN L | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | — | $37 | 0.06% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $25 | — | $25 | 0.04% |
| SHORT JACK L3 | 176 PATTI DRIVE SUITE 105 WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| KEELER & ASSOCIATES3 | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 4.86% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $817 | — | $817 | 1.30% |
| 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 | $392 | — | $392 | 0.62% |
| MOSELEY NICOLE3 | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $76 | — | $76 | 0.12% |
| GORDON JESSICA3 | 2955 SYCAMORE LANE BLOOMSBURG, PA 17815 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $68 | — | $68 | 0.11% |
| TROIANO JOSEPH E3 | 2854 LYTLE ROAD CENTERBURG, OH 43011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $68 | — | $68 | 0.11% |
| DENNIS GAYLE3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINEE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $60 | — | $60 | 0.10% |
| MOSELEY GARY L3 | 1760 TOWNSHIP ROAD 55 BELLEFONTAINE, OH 43311 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $31 | — | $31 | 0.05% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.03% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.03% |
| MOSELEY NICOLE3 Filed as: MOSELEY SHAWN L | 3700 SHAGBARK TRAIL GALENA, OH 43021 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| SHORT JACK L3 | 176 PATTI DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| INSGROUP INC3 Filed as: FIRST INSURANCE GROUP OF THE MIDWES | 511 5TH STREET DEFIANCE, OH 43512 | MEDICAL MUTUAL OF OHIO | $79K | $4K | $83K | 187.37% |
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 | 836 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 92 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 944 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 1,015 | $352K |
| Vision | VISION SERVICE PLAN | 438 | $109K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 696 | $293K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 696 | $230K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SWISS RE | 478 | $587K |
| Other(4 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 857 | $372K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,015 | — |
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.