| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | ANTHEM INSURANCE COMPANIES, INC. | $23K | — | $23K | 3.20% |
| INDY CHAMBER LLC3 | 111 MONUMENT CIRCLE SUITE 1950 INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES, INC. | $468 | — | $468 | 0.06% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | ANTHEM INSURANCE COMPANIES, INC. | $2K | — | $2K | 2.46% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 462500435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $144 | $3K | 15.68% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 9.24% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 182 | $733K |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 87 | $85K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 182 | $733K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 109 | $14K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $19K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 109 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.