| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3600 AMERICAN BLVD W SUITE 500 MINNEAPOLIS, MN 55431 | BARDON INSURANCE | $33K | — | $33K | 11.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PARK CENTRAL 7/ 12750 MERIT DR SUITE 1000 DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY | $5K | $364 | $6K | 6.08% |
| CHARLES HOWARD JOBE3 Filed as: CHARLES E ROSCOE | 2085 PARKVIEW DR TWINSBURG, OH 44087 | AFLAC | $3K | $194 | $3K | 7.32% |
| SHARON BENNETT3 | 6166 OAKES ROAD BRECKSVILLE, OH 44141 | AFLAC | $766 | — | $766 | 1.76% |
| ANGELA FANKHAUSER3 Filed as: ANGELA M FANKHAUSER | 34030 MAPLE DR SOLON, OH 44139 | AFLAC | $613 | $39 | $652 | 1.50% |
| MAKOWSKI INS AGCY INC3 | 9404 WOODCHIP LN BROADVIEW HTS, OH 44147 | AFLAC | $539 | $39 | $578 | 1.33% |
| STEVEN M MAZUR3 | 6415 MONMOUTH RD CLEVELAND, OH 44129 | AFLAC | $289 | — | $289 | 0.66% |
| STEPHEN BRIAN LOMBARDOZZI3 | 5329 GARGASZ DR LORAIN, OH 44053 | AFLAC | $174 | — | $174 | 0.40% |
| KEVIN WRONA3 Filed as: KEVIN M WRONA | 4086 FAR O WAY LN RICHFIELD, OH 44286 | AFLAC | $153 | — | $153 | 0.35% |
| EUGENE MAKOWSKI3 | 8442 LIDO DR BROADVIEW HEIGHTS, OH 44147 | AFLAC | $146 | — | $146 | 0.33% |
| TIMOTHY R QUINLAN3 | 137 SEMICONON LN RENFREW, PA 16053 | AFLAC | $81 | — | $81 | 0.19% |
| ANTHONY P OLSZKO3 | 7322 MEADOW BROOKE WAY NORTHFIELD, OH 44067 | AFLAC | $58 | — | $58 | 0.13% |
| HENSLEY AND ASSOCIATES LLC3 | 9465 RIVIERA DR UNION, KY 41091 | AFLAC | $50 | — | $50 | 0.11% |
| ROBERTA DICKINSON3 Filed as: ROBERTA S. DICKINSON | PO BOX 360277 STRONGSVILLE, OH 44136 | AFLAC | $29 | — | $29 | 0.07% |
| GLORIA MARIE FELICIANO JIMENEZ3 | 10123 GREENVIEW AVE CLEVELAND, OH 44125 | AFLAC | $27 | — | $27 | 0.06% |
| TRACY M HABART-GARTMAN3 | 5209 YORTON LN BRUNSWICK, OH 44212 | AFLAC | $22 | — | $22 | 0.05% |
| QUINN, MEYER & ASSOCIATES3 | 10800 WINCHCOMBE DR DUBLIN, OH 43016 | AFLAC | $21 | — | $21 | 0.05% |
| HARE AND ASSOCIATES LLC3 | 6324 TARTON FIELDS LN MASON, OH 45040 | AFLAC | $20 | — | $20 | 0.05% |
| OPPORTUNITY INC3 | 9404 WOODCHIP LN BROADVIEW HEIGHTS, OH 44147 | AFLAC | $19 | — | $19 | 0.04% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AFLAC | $18 | — | $18 | 0.04% |
| JACK A SHADE3 Filed as: JACK SHADE | 690 TREE BEND CT WESTERVILLE, OH 43082 | AFLAC | $6 | — | $6 | 0.01% |
| 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 | $3 | — | $3 | 0.01% |
| JOHN D SUSIE3 | 8682 HAWICK CT N DUBLIN, OH 43017 | AFLAC | $2 | — | $2 | 0.00% |
| 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 | 718 HOYT AVE E SUITE 201 SAINT PAUL, 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 INS. COMPANY - ALLSTATE | $39 | — | $39 | 4.19% |
| MILLWOOD ASSOCIATES3 Filed as: MILLWOOD ASSOCIATES LLC | P.O. BOX 124 TALLMADGE, OH 44278 | AMERICAN HERITAGE LIFE INS. COMPANY - ALLSTATE | $16 | — | $16 | 1.72% |
| LINDA LEE BOSTON3 Filed as: LINDA LEE STAIF-BOSTON | 1275 W MAPLE ST HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INS. COMPANY - ALLSTATE | $9 | — | $9 | 0.97% |
| CHRISTOPHER J CONLEY3 | 5206 YORKSHIRE RD PARMA, OH 44134 | AMERICAN HERITAGE LIFE INS. COMPANY - ALLSTATE | $8 | — | $8 | 0.86% |
| THOMAS W BOSTON3 | 1275 W MAPLE ST HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INS. COMPANY - ALLSTATE | $7 | — | $7 | 0.75% |
| DAVID MARTIN MCLAUGHLIN3 | 20898 DRAKE RD STRONGSVILLE, OH 44149 | AMERICAN HERITAGE LIFE INS. COMPANY - ALLSTATE | $4 | — | $4 | 0.43% |
| TOM DENNISON AGENCY INC3 | 3034 CLIFFSIDE DR COPLEY, OH 44321 | AMERICAN HERITAGE LIFE INS. COMPANY - ALLSTATE | $2 | — | $2 | 0.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MUTUAL HEALTH SERVICES EIN 34-0648820 TPA | Contract Administrator Service code 13 | — | $62K |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BARDON INSURANCE | 106 | $276K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 194 | $96K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 194 | $96K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 194 | $96K |
| Short-term disability | AFLAC | 56 | $44K |
| Stop-loss / reinsurancereinsurance | BARDON INSURANCE | 106 | $276K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 194 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.