| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SCOTT GROUP BENEFITS SPEC LLC3 Filed as: THE SCOTT GROUP BENEFIT SPECIALISTS | 8320 ALLISON POINTE BLVD INDIANAPOLIS, IN 462500530 | HEALTH RESOURCES, INC. | $7K | — | $7K | 10.00% |
| CAIRNSTONE FINANCIAL LLC3 Filed as: CAIRNSTONE FINANCIAL, LLC | P.O. BOX 50530 INDIANAPOLIS, IN 462500530 | VISION SERVICE PLAN | $1K | — | $1K | 3.08% |
| THE SCOTT GROUP BENEFITS SPEC LLC3 Filed as: THE SCOTT GROUP BENEFIT SPECIALISTS | 8320 ALLISON POINTE BLVD INDIANAPOLIS, IN 462501696 | VISION SERVICE PLAN | $377 | — | $377 | 0.86% |
| CAIRNSTONE FINANCIAL LLC3 Filed as: CAIRNSTONE FINANCIAL, LLC | P.O. BOX 50530 INDIANAPOLIS, IN 462500530 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| CAIRNSTONE FINANCIAL LLC3 Filed as: CAIRNSTONE FINANCIAL, LLC | P.O. BOX 50530 INDIANAPOLIS, IN 462500530 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| CAIRNSTONE FINANCIAL LLC3 Filed as: CAIRNSTONE FINANCIAL, LLC | P.O. BOX 50530 INDIANAPOLIS, IA 462500530 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $834 | — | $834 | 15.01% |
| CAIRNSTONE FINANCIAL LLC3 Filed as: CAIRNSTONE FINANCIAL, LLC | P.O. BOX 50530 INDIANAPOLIS, IN 462500530 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $269 | — | $269 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other commissions; Contract Administrator; Float revenue; Insurance agents and brokers; Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $236K |
| NETWORK PHARMACY MARGIN NONE | Other fees Service code 99 | — | $8K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 NONE | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $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 | 570 | 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) | 570 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 293 | $415K |
| Dental | HEALTH RESOURCES, INC. | 205 | $75K |
| Vision | VISION SERVICE PLAN | 210 | $44K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 570 | $11K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 36 | $6K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 36 | $9K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 293 | $415K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 570 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 570 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.