| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | HARTFORD LIFE AND ACCIDENT | $109K | $0 | $109K | 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 | $64K | $64K | 5.89% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET, SUITE 400 SOUTH BEND, IN 46601 | DELTA DENTAL OF INDIANA | $18K | $0 | $18K | 3.00% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | $0 | $16K | 9.71% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.01% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.74% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | ZURICH AMERICAN INSURANCE COMPANY | $380 | $0 | $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 | 1,658 | 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) | 1,658 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 542 | $2.6M |
| Dental | DELTA DENTAL OF INDIANA | 2,166 | $606K |
| Vision(2 contracts, 2 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 884 | $2.5M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,658 | $1.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,658 | $1.1M |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,658 | $1.2M |
| Prescription drug(3 contracts, 3 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 542 | $2.6M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 1,658 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,166 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.