| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE ONE BENEFITS3 Filed as: CORPORATE ONE BENEFITS AGENCY, INC. | 1650 N COUNTY LINES STREET, SUITE 2 FOSTORIA, OH 44830 | MEDICAL MUTUAL OF OHIO | $28K | $3K | $31K | 13.76% |
| CORPORATE ONE BENEFITS3 | 220 PERRY ST, SUITE 200 FOSTORIA, OH 44830 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $3K | $17K | 20.68% |
| NORTHWEST WORKSITE MARKETING CORP3 | 1910 INDIANWOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $357 | $7K | 10.01% |
| WILLIAM H. MEYER AGENCY, INC.3 Filed as: WILLIAM H MEYER AGY INC. | 1660 NW PROFESSIONAL PLAZA COLUMBUS, OH 43220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.77% |
| TERRY REICHENBACH3 Filed as: TERRY L REICHENBACH | PO BOX 178 PANDORA, OH 45877 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.31% |
| DAVID L SMELCER3 | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 0.17% |
| PHILLIP M ROEDER3 | 1910 INDIAN WOOD TERRACE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 0.17% |
| STRATEGIC ENROLLMENT SERVICES INC.3 Filed as: STRATEGIC ENROLLMENT SERVICES INC | 1205 LOUISIANA AVE STE 441 PERRYSBURG, OH 43552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.15% |
| D STEVEN SMELCER3 | 7676 MEHAFFEY RD LIMA, OH 45801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.11% |
| DEBRA TORRES3 Filed as: DEBRA K TORRES | 3360 ADA RD LIMA, OH 45801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.07% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE ONE BENEFITS AGCY INC | PO BOX 906 220 PERRY STREET, SUITE 200 FOSTORIA, OH 448300906 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $4K | $2K | $6K | 15.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL MUTUAL SERVICES EIN 34-1922587 NONE | Contract Administrator Service code 13 | 2060 EAST NINTH STREET CLEVELAND, OH 44115 | $59K |
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 | 221 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $81K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $81K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $147K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 221 | $36K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 165 | $224K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.