| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | UNITEDHEALTHCARE INSURANCE COMPANY | $20K | $0 | $20K | 0.97% |
| GIBSON INSURANCE AGENCY, INC.3 | PO BOX 11107 FORT WAYNE, IN 46855 | HARTFORD LIFE AND ACCIDENT | $122K | $0 | $122K | 10.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES, LLC | 1933 STATE ROUTE 35, SUITE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | $0 | $75K | $75K | 6.16% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET, SUITE 400 SOUTH BEND, IN 46601 | DELTA DENTAL OF INDIANA | $19K | $0 | $19K | 3.01% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $343 | $5K | 5.01% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $917 | $18 | $935 | 1.02% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | ZURICH AMERICAN INSURANCE COMPANY | $380 | — | $380 | 14.98% |
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 | 1,698 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 574 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 906 | $2.6M |
| Dental | DELTA DENTAL OF INDIANA | 2,144 | $647K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 906 | $2.1M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,874 | $1.2M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,698 | $0 |
| Long-term disability(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,874 | $1.3M |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 906 | $2.6M |
| Other(6 contracts, 6 carriers) | HARTFORD LIFE AND ACCIDENT | 1,874 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,144 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.