| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURED NEACE LUKENS INS. AGENCY3 Filed as: ASSURED NEACE LUKENS INS AGENCY INC | 5005 ROCKSIDE RD INDEPENDENCE, OH 44131 | BARDON INSURANCE | $33K | — | $33K | 15.37% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL,LLC | 2305 RIVER ROAD LOUISVILLE, KY 40206 | THE GUARDIAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 3600 AMERICAN BLVD W SUITE 500 MINNEAPOLIS, MN 55431 | THE GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.80% |
| CHARLES HOWARD JOBE3 Filed as: CHARLES E ROSCOE | 2085 PARKVIEW DR TWINSBURG, OH 44087 | AFLAC | $5K | $246 | $6K | 12.41% |
| ANGELA FANKHAUSER3 Filed as: ANGELA M FANKHAUSER | 34030 MAPLE DR SOLON, OH 44139 | AFLAC | $1K | $37 | $1K | 2.37% |
| MAKOWSKI INS AGCY INC3 | 9404 WOODCHIP LN BROADVIEW HTS, OH 44147 | AFLAC | $862 | $49 | $911 | 2.01% |
| SHARON BENNETT3 | 6166 OAKES ROAD BRECKSVILLE, OH 44141 | AFLAC | $828 | — | $828 | 1.82% |
| STEVEN M MAZUR3 | 6415 MONMOUTH RD CLEVELAND, OH 44129 | AFLAC | $321 | — | $321 | 0.71% |
| STEPHEN BRIAN LOMBARDOZZI3 | 5329 GARGASZ DR LORAIN, OH 44053 | AFLAC | $216 | $12 | $228 | 0.50% |
| KEVIN WRONA3 Filed as: KEVIN M WRONA | 4086 FAR O WAY LN RICHFIELD, OH 44286 | AFLAC | $167 | — | $167 | 0.37% |
| EUGENE MAKOWSKI3 | 8442 LIDO DR BROADVIEW HEIGHTS, OH 44147 | AFLAC | $166 | — | $166 | 0.37% |
| TIMOTHY R QUINLAN3 | 137 SEMICONON LN RENFREW, PA 16053 | AFLAC | $101 | — | $101 | 0.22% |
| ANTHONY P OLSZKO3 | 7322 MEADOW BROOKE WAY NORTHFIELD, OH 44067 | AFLAC | $62 | — | $62 | 0.14% |
| HENSLEY AND ASSOCIATES LLC3 | 1103 SCHROCK RD STE 201 COLUMBUS, OH 43229 | AFLAC | $34 | — | $34 | 0.07% |
| ROBERTA DICKINSON3 Filed as: ROBERTA S. DICKINSON | PO BOX 360277 STRONGSVILLE, OH 44136 | AFLAC | $30 | — | $30 | 0.07% |
| GLORIA MARIE FELICIANO JIMENEZ3 | 10123 GREENVIEW AVE CLEVELAND, OH 44125 | AFLAC | $25 | — | $25 | 0.06% |
| HARE AND ASSOCIATES LLC3 | 6324 TARTON FIELDS LN MASON, OH 45040 | AFLAC | $24 | — | $24 | 0.05% |
| HENSLEY AND ASSOCIATES LLC4 | 9465 RIVIERA DR UNION, KY 41091 | AFLAC | $23 | — | $23 | 0.05% |
| TRACY M HABART-GARTMAN3 | 5209 YORTON LN BRUNSWICK, OH 44212 | AFLAC | $21 | — | $21 | 0.05% |
| OPPORTUNITY INC3 | 9404 WOODCHIP LN BROADVIEW HEIGHTS, OH 44147 | AFLAC | $21 | — | $21 | 0.05% |
| QUINN, MEYER & ASSOCIATES3 | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $20 | — | $20 | 0.04% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AFLAC | $17 | — | $17 | 0.04% |
| JACK A SHADE3 Filed as: JACK SHADE | 690 TREE BEND CT WESTERVILLE, OH 43082 | AFLAC | $7 | — | $7 | 0.02% |
| JOHN C RASCHELLA3 Filed as: JOHN RASCHELLA | 20521 TAHITIAN BLVD ESTERO, FL 33928 | AFLAC | $4 | — | $4 | 0.01% |
| RONALD J GRETHEL3 Filed as: RONALD GRETHEL | 648 HANNA AVE LOVELAND, OH 45140 | AFLAC | $4 | — | $4 | 0.01% |
| RICO PEREZ3 | 6000 LOMBARDO CTR STE 145 SEVEN HILLS, OH 44131 | AFLAC | $4 | — | $4 | 0.01% |
| JOHN D SUSIE3 | 8682 HAWICK CT N DUBLIN, OH 43017 | AFLAC | $3 | — | $3 | 0.01% |
| LISA CUNNINGHAM3 | 8078 POLK PATH REYNOLDSBURG, OH 43068 | AFLAC | $2 | — | $2 | 0.00% |
| RPM LTD3 | PO BOX 484 BLOOMINGDALE, GA 31302 | AFLAC | $1 | — | $1 | 0.00% |
| KRISTEN EDGE3 | 8328 BURLINGTON DR NORTH RIDGEVILLE, OH 44039 | AFLAC | $1 | — | $1 | 0.00% |
| KARA M CARMODY3 | 22260 445TH AVE SUITE 201 RAMONA, SD 57054 | AFLAC | $1 | — | $1 | 0.00% |
| GEORGE EDWARD MARSINEK JR3 Filed as: GEORGE EDWARD MARSINEK, JR | 3920 WEBB RD RAVENNA, OH 44266 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $45 | — | $45 | 4.14% |
| NICHOLAS FUCIO3 | 2234 RIVERFRONT PKWY CUYAHOGA FALLS, OH 44221 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $24 | — | $24 | 2.21% |
| LINDA LEE BOSTON3 Filed as: LINDA LEE STAIF-BOSTON | 13661 MARKET AVE N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $10 | — | $10 | 0.92% |
| CHRISTOPHER J CONLEY3 | 5206 YORKSHIRE RD PARMA, OH 44134 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $10 | — | $10 | 0.92% |
| THOMAS W BOSTON3 | 13661 MARKET AVE N HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $9 | — | $9 | 0.83% |
| DAVID MARTIN MCLAUGHLIN3 | 20898 DRAKE RD STRONGSVILLE, OH 44149 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $5 | — | $5 | 0.46% |
| TOM DENNISON AGENCY INC3 | 3034 CLIFFSIDE DR COPLEY, OH 44321 | AMERICAN HERITAGE LIFE INSURANC COMPANY - ALLSTATE | $2 | — | $2 | 0.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MUTUAL HEALTH SERVICES EIN 34-0648820 TPA | Contract Administrator Service code 13 | — | $61K |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BARDON INSURANCE | 109 | $216K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 117 | $88K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 117 | $88K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 117 | $88K |
| Short-term disability | AFLAC | 60 | $45K |
| Stop-loss / reinsurancereinsurance | BARDON INSURANCE | 109 | $216K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 117 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.