| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | 1630 H STREET BEDFORD, IN 47421 | ANTHEM INSURANCE COMPANIES, INC. | $23K | $0 | $23K | 2.82% |
| ASSUREDPARTNERS3 | 4500 TOWN CENTER BOULEVARD SUITE 200 JEFFERSONVILLE, IN 47130 | ANTHEM INSURANCE COMPANIES, INC. | $11K | $0 | $11K | 1.35% |
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | 1630 H STREET BEDFORD, KY 47421 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.67% |
| ASSUREDPARTNERS3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $168 | $2K | 4.72% |
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | 1630 H STREET BEDFORD, KY 47421 | SYMETRA LIFE INSURANCE COMPANY | $569 | $134 | $703 | 8.94% |
| ASSUREDPARTNERS3 | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | SYMETRA LIFE INSURANCE COMPANY | $611 | $60 | $671 | 8.53% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 152 | $826K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $43K |
| Vision(2 contracts, 2 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 152 | $869K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 106 | $8K |
| Prescription drug | ANTHEM INSURANCE COMPANIES, INC. | 152 | $826K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 106 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.