| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | HARTFORD LIFE AND ACCIDENT | $34K | $7K | $41K | 12.21% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET, SUITE 5200 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $5K | $5K | 1.37% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | DELTA DENTAL OF INDIANA | $29K | $0 | $29K | 9.11% |
| SUSAN MARIE BARD3 Filed as: SUSAN BARD | 7219 DERSTAN ROAD INDIANAPOLIS, IN 46250 | AFLAC | $4K | $19 | $4K | 8.38% |
| DIAN FAH3 | 122 PINE STREET GLENWOOD CITY, WI 54013 | AFLAC | $1K | $14 | $1K | 2.87% |
| BRIANNA LYNN ROWE3 Filed as: BRIANNA ROWE | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $856 | $0 | $856 | 1.87% |
| MJ INSURANCE3 Filed as: MARIA VONDIELINGEN & VARIOUS AGENTS | 9912 RIDGE DRIVE INDIANAPOLIS, IN 46256 | AFLAC | $772 | $4 | $776 | 1.69% |
| TAD HOWARD ASP3 Filed as: TAD ASP | 10890 NORTH SMITH ROAD HAYWARD, WI 54843 | AFLAC | $503 | $10 | $513 | 1.12% |
| HOLLY RENEE ASHLEY3 Filed as: HOLLY ASHLEY | 720 SOUTH RANGELINE ROAD APARTMENT 419 CARMEL, IN 46032 | AFLAC | $470 | $4 | $474 | 1.03% |
| MICHAEL BECK3 | 2406 IVY AVENUE FORT MYERS, FL 33907 | AFLAC | $298 | $10 | $308 | 0.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: EQUITY RISK PARTNERS INS. SERVICES | 580 CALIFORNIA STREET, SUITE 1300 SAN FRANCISCO, CA 94104 | FEDERAL INSURANCE COMPANY | $225 | $34 | $259 | 17.27% |
| GETTYSBURGH BENEFITS ADMIN., INC.3 | PO BOX 1060 GETTYSBURG, PA 17325 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $96 | $0 | $96 | 6.59% |
| CBIZ BENEFITS & INSURANCE SERVICES Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | $0 | $22 | 1.51% |
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 | 411 | 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) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 731 | $323K |
| Vision | VISION SERVICE PLAN | 351 | $70K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 411 | $339K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 411 | $339K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 411 | $339K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 411 | $388K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 731 | — |
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.