| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURAMAX INC3 | 2200 GREENE WAY LOUISVILLE, KY 40220 | DELTA DENTAL OF MINNESOTA | $12K | — | $12K | 8.92% |
| INSURAMAX INC3 | 2200 GREENE WAY LOUISVILLE, KY 40250 | AMERICA UNITED LIFE INSURANCE COMPANY | $9K | — | $9K | 19.30% |
| INSURAMAX INC3 | 2200 GREENE WAY LOUISVILLE, KY 40250 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $868 | — | $868 | 5.11% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS | 13800 JACKSON RD MISHAWAKA, IN 46544 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $820 | — | $820 | 4.83% |
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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 225 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 151 | $17K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 151 | $17K |
| Life insurance(2 contracts, 2 carriers) | AMERICA UNITED LIFE INSURANCE COMPANY | 319 | $63K |
| Short-term disability(2 contracts, 2 carriers) | AMERICA UNITED LIFE INSURANCE COMPANY | 319 | $63K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 151 | $17K |
| Other(2 contracts, 2 carriers) | AMERICA UNITED LIFE INSURANCE COMPANY | 319 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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."
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.