| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | SYMETRA LIFE INSURANCE COMPANY | $225K | $27K | $252K | 20.70% |
| TIMOTHY D. LEMAN3 Filed as: C TIMOTHY LEMAN | PO BOX 11177 SOUTH BEND, IN 46634 | DELTA DENTAL OF INDIANA | $33K | — | $33K | 9.22% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 466340177 | VISION SERVICE PLAN | — | $12K | $12K | 31.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NAMIC SERVICE CORPORATION EIN 35-1176317 NONE | Consulting (general) Service code 16 | 3601 VINCENNES ROAD INDIANAPOLIS, IN 46268 | $252K |
| BENELOGIC LLC EIN 52-2266758 NONE | Contract Administrator Service code 13 | 9475 DEERECO ROAD STE 310 TIMONIUM, MD 21093 | $31K |
| DOUG JENSEN NONE | Named fiduciary Service code 31 | 8743 FERRARA COURT NAPLES, FL 341142718 | $25K |
| ICSO HUMAN RESOURCES ASSOCTN INC. EIN 46-5048228 NONE | Consulting (general) Service code 16 | 3601 VINCENNES ROAD INDINAPOLIS, IN 46268 | $20K |
| L.M. HENDERSON & COMPANY, LLP EIN 20-5520612 NONE | Accounting (including auditing) Service code 10 | 450 E 96TH STREET STE 200 INDIANAPOLIS, IN 46240 | $17K |
| SIBSON CONSULTING EIN 13-1835864 NONE | Direct payment from the plan Service code 50 | 30 WATERSIDE DR, STE 300 FARMINGTON, CT 06032 | $16K |
| WILLIS TOWERS WATSON VIA BENEFITS EIN 20-2487260 NONE | Direct payment from the plan Service code 50 | 10975 S STERLING VIEW DR SOUTH JORDAN, UT 84095 | $11K |
| CONNECTYOURCARE FSA EIN 81-0569632 NONE | Direct payment from the plan Service code 50 | 307 INTERNATIONAL CIR 200 HUNT VALLYE, MD 21030 | $8K |
| PNC BANK NA EIN 25-1211909 NONE | Direct payment from the plan Service code 50 | 249 FIFTH AVE, ONE PNC PL PITTSBURGH, PA 15222 | $8K |
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 | 598 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 368 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 966 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 860 | $360K |
| Vision | VISION SERVICE PLAN | 340 | $38K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 946 | $1.2M |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 946 | $1.2M |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 946 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 946 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.