| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | 333 E JEFFERSON STREET PLYMOUTH, IN 46563 | ANTHEM INSURANCE COMPANIES | $65K | — | $65K | 9.26% |
| THE INSURANCE EXCHANGE INC3 Filed as: INSURANCE EXCHANGE INC. | 9713 KEY WEST AVE SUITE 401 ROCKVILLE, MD 20850 | ANTHEM INSURANCE COMPANIES | $60K | — | $60K | 8.64% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | PO BOX 610 333 E. JEFFERSON PLYMOUTH, IN 46563 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $1K | $26K | 17.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC. | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20874 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17K | $546 | $18K | 25.21% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $693 | $693 | 0.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC. | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20874 | UNUM LIFE INSURANCE OF AMERICA | $15K | $470 | $16K | 26.77% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | PO BOX 610 333 E. JEFFERSON PLYMOUTH, IN 46563 | UNUM LIFE INSURANCE OF AMERICA | $231 | — | $231 | 0.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Other fees; Claims processing; Float revenue Service code 12 | — | $995K |
| UMR INSURANCE COMPANIES EIN 39-1995276 CLAIMS PROCESSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Other services; Claims processing; Other fees; Contract Administrator; Float revenue Service code 12 | — | $384K |
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 CLAIMS PROCESSOR | Contract Administrator; Claims processing; Insurance agents and brokers; Other fees; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $233K |
| COORDINATED CARE PROGRAMS LLC COORDINATED CARE | Direct payment from the plan; Other fees Service code 50 | 44 W 28TH STREET NEW YORK, NY 10001 | $223K |
| BENEFIT TECHNOLOGY RESOURCES, LLC COMPUTER SERVICE | Other services; Direct payment from the plan Service code 49 | 1700 N BROADWAY AVENUE SUITE 116 ROCHESTER, MN 55901 | $52K |
| DELTA DENTAL EIN 35-1545647 BENEFIT ADMINISTRATOR | Other fees; Direct payment from the plan Service code 50 | — | $24K |
| BASIC EIN 38-2883561 COBRA ADMIN FEES | Direct payment from the plan; Contract Administrator Service code 13 | — | $9K |
| MDX MEDICAL, INC. COST EFFECTIVE CARE | Direct payment from the plan; Other fees Service code 50 | 160 CHUBB AVENUE #301 LYNDHURST, NJ 07071 | $8K |
| EDISON HEALTHCARE COST EFFECTIVE CARE | Direct payment from the plan; Other fees Service code 50 | 100 S. RIVERFRONT DRIVE SUITE 400 JENKS, OK 74037 | $7K |
| RX HELP CENTER, LLC EIN 46-2125122 COST EFFECTIVE CARE | Direct payment from the plan; Other fees Service code 50 | — | $6K |
| ANTHEM INSURANCE COMPANIES, INC. | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | — | $0 |
| GIBSON INSURANCE AGENCY INC. | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| INSURANCE EXCHANGE, INC. | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
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 | 1,257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ANTHEM INSURANCE COMPANIES | 782 | $699K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 879 | $274K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 879 | $125K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 879 | $55K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | ANTHEM INSURANCE COMPANIES | 879 | $1.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 471 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 879 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.