| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD CARMEL, IN 46032 | DELTA DENTAL OF INDIANA | $21K | — | $21K | 5.94% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $3K | $10K | 14.23% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $3K | $10K | 14.14% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $2K | $8K | 14.18% |
| SUSAN MARIE BARD3 Filed as: SUSAN BARD | 7219 DERSTAN ROAD INDIANAPOLIS, IN 46250 | AFLAC | $5K | $1K | $6K | 13.33% |
| BRIANNA LYNN ROWE3 Filed as: BRIANNA ROWE | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $2K | $432 | $3K | 5.82% |
| JOHN J HINDS3 Filed as: JOHN HINDS | 12 HONEYSUCKLE LANE GOFFSTOWN, NH 03045 | AFLAC | $446 | $65 | $511 | 1.05% |
| DAVID W SCOTT3 Filed as: DAVID SCOTT | 131 EAST EXCHANGE AVENUE SUITE 128 FORT WORTH, TX 76164 | AFLAC | $214 | $46 | $260 | 0.53% |
| BENJAMIN HUNTER3 | 11193 GUY STREET FISHERS, IN 46038 | AFLAC | $148 | — | $148 | 0.30% |
| CHARLES LAWSON3 Filed as: CHARLES GLEN LAWSON | 1919 EASTSIDE LAKE ROAD GRAHAM, TX 76450 | AFLAC | $76 | $26 | $102 | 0.21% |
| BENJAMIN HUNTER3 | 18401 AVEBURY LANE WESTFIELD, IN 46062 | AFLAC | $84 | — | $84 | 0.17% |
| KEVIN DELANEY3 | 2 SWAN TERRACE GREENLAND, NH 03840 | AFLAC | $70 | $13 | $83 | 0.17% |
| JONATHAN BURGESS3 | 434 DONALD STREET BEDFORD, NH 03110 | AFLAC | $52 | $13 | $65 | 0.13% |
| MARY CATHERINE WILLIAMS3 Filed as: MARY WILLIAMS | 1102 STEVENS STREET SUITE 1 BRIDGEPORT, TX 76426 | AFLAC | $48 | $12 | $60 | 0.12% |
| KEVIN DELANEY3 | 2 FAIRVIEW TERRACE GREENLAND, NH 03840 | AFLAC | $54 | — | $54 | 0.11% |
| JOSEPH HUGHES3 | 1347 HILLANDALE AVENUE UNIT D LA HABRA, CA 90631 | AFLAC | $37 | $12 | $49 | 0.10% |
| CRYSTAL ANN DAVILA3 Filed as: CRYSTAL DAVILA | 5317 LAVA ROCK DRIVE FORT WORTH, TX 76179 | AFLAC | $37 | — | $37 | 0.08% |
| TAD HOWARD ASP3 | 10890 NORTH SMITH ROAD HAYWARD, WI 54843 | AFLAC | $23 | — | $23 | 0.05% |
| JONATHAN BURGESS3 | 434 DONALD STREET BEDFORD, NH 03110 | AFLAC | $22 | — | $22 | 0.05% |
| CYNTHIA LUQUIN3 | 2220 EAST ROUTE 66 SUITE 215 GLENDORA, CA 91740 | AFLAC | $18 | $2 | $20 | 0.04% |
| DAVID REESOR3 | 2220 EAST ROUTE 66 SUITE 215 GLENDORA, CA 91740 | AFLAC | $9 | $2 | $11 | 0.02% |
| CLARIBEL LOZA3 | 6045 SIDEWINDER TRAIL FORT WORTH, TX 76131 | AFLAC | $4 | — | $4 | 0.01% |
| SAMANTHA MICHAELSON3 Filed as: SAMANTHA BREUER | 101 NORTH FARWELL STREET SUITE 203 EAU CLAIRE, WI 54703 | AFLAC | $3 | — | $3 | 0.01% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $2K | $5K | 14.18% |
| GETTYSBURG BENEFITS ADMINISTRATION3 | P.O. BOX 1060 GETTYSBURG, PA 17325 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $406 | — | $406 | 5.64% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 452632886 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $190 | — | $190 | 2.64% |
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 | 381 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 746 | $4.2M |
| Dental | DELTA DENTAL OF INDIANA | 720 | $359K |
| Vision | VISION SERVICE PLAN | 334 | $64K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 381 | $126K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 381 | $37K |
| Other(5 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 381 | $182K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 746 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.