| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | GUARDIAN | $13K | $764 | $13K | 13.30% |
| HORAN ASSOCIATES INC.3 Filed as: HORAN ASSOCIATES, INC. | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 452362950 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 3.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 452362950 | AMERITAS LIFE INSURANCE CORP. | $748 | — | $748 | 1.22% |
| HORAN ASSOCIATES INC.3 Filed as: HORAN ASSOCIATES INC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $12K | — | $12K | 24.62% |
| LORI LYNN PIERCE3 | 5909 CINNAMON OAKS DR CORPUS CHRISTI, TX 784142503 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $4K | — | $4K | 7.23% |
| BRIAN W PATTEN3 Filed as: BRIAN WILLIAM PATTEN | 121 BUCKTHORN RD BADEN, PA 150052561 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $3K | — | $3K | 6.88% |
| DANIEL C HARRIS3 | 413 OAK RIDGE COURT MARS, PA 16046 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $2K | — | $2K | 3.40% |
| TRISTAN GAINES3 Filed as: TRISTAN EMANUEL GAINES | 1985 BRANDYWINE DR NEW BRAUNFELS, TX 781302602 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $1K | — | $1K | 2.66% |
| KRISTEN NICOLE WILKINS3 | 287 DERRY RIDGE ROAD LIGONIER, PA 15658 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $1K | — | $1K | 2.64% |
| BRIAN HARTNETT3 | 109 CALUMET DRIVE SYRACUSE, NY 132192905 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $1K | — | $1K | 2.50% |
| KARY L BREEZE3 | 7114 KY HWY 1234 S MAYSVILLE, KY 41056 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $359 | — | $359 | 0.73% |
| MATTHEW RYAN KIRKWOOD3 | 337 FIELDSRUN ROAD NEW CASTLE, PA 16105 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $298 | — | $298 | 0.61% |
| SANDY JACKSON BOSWEL3 | 790 RIVER ROAD WEST POINT, VA 23181 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $290 | — | $290 | 0.59% |
| JEFFREY CORREAL3 Filed as: JEFFREY SCOTT CORREAL | 442 DUCK HOLLOW RD UNIONTOWN, PA 154018956 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $260 | — | $260 | 0.53% |
| JORDAN RYAN CHESTER3 | 8253 JELLISON ST ORLANDO, FL 32825 | CONTINENTAL AMERICAN INSURANCE COMPANY57-0514130 | $34 | — | $34 | 0.07% |
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 | 365 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 366 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 585 | $61K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 585 | $61K |
| Life insurance | GUARDIAN | 401 | $101K |
| Short-term disability | GUARDIAN | 401 | $101K |
| Long-term disability | GUARDIAN | 401 | $101K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 401 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 585 | — |
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.