| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $40K | $17K | $58K | 13.05% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES, LLC | 1933 STATE ROUTE 35 WALL, NJ 07719 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $20K | $20K | 4.57% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | DELTA DENTAL OF INDIANA | $35K | $377 | $36K | 10.01% |
| SUSAN MARIE BARD3 Filed as: SUSAN BARD | 7219 DERSTAN ROAD INDIANAPOLIS, IN 46250 | AFLAC | $1K | $0 | $1K | 3.80% |
| BRIANNA LYNN ROWE3 Filed as: BRIANNA ROWE | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $559 | $0 | $559 | 1.80% |
| JOHN HINDS AND OTHER AGENTS3 | 130 EBONY STREET FAIRHAVEN, MA 02719 | AFLAC | $454 | $29 | $483 | 1.56% |
| TAD HOWARD ASP3 Filed as: TAD ASP | 10890 NORTH SMITH ROAD HAYWARD, WI 54843 | AFLAC | $236 | $3 | $239 | 0.77% |
| DAVID SCOTT3 | 695 ROADRUNNER TRAIL RIESEL, TX 76682 | AFLAC | $122 | $0 | $122 | 0.39% |
| HOLLY RENEE ASHLEY3 Filed as: HOLLY ASHLEY | 1483 SPRUCE DRIVE CARMEL, IN 46033 | AFLAC | $105 | $0 | $105 | 0.34% |
| DIANE WELCH3 | 545 NORTH 8TH STREET RIVER FALLS, WI 54022 | AFLAC | $87 | $3 | $90 | 0.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: EQUITY RISK PARTNERS INS SERVICES | 90 NEW MONTGOMERY, SUITE 250 SAN FRANCISCO, CA 94105 | FEDERAL INSURANCE COMPANY | $225 | $22 | $247 | 16.47% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC. INS. GROUP, INC. | 1 KELLY WAY SPARKS, MD 21152 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $86 | $0 | $86 | 6.69% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | $0 | $19 | 1.48% |
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 | 482 | 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) | 483 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 762 | $357K |
| Vision | VISION SERVICE PLAN | 411 | $73K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 482 | $441K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 482 | $441K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 482 | $441K |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 482 | $475K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 762 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.