| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | ANTHEM INSURANCE COMPANIES, INC. | $39K | $446 | $39K | 2.49% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | DELTA DENTAL OF INDIANA | $9K | $0 | $9K | 9.56% |
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | ANTHEM LIFE INSURANCE COMPANY | $8K | $0 | $8K | 11.80% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $506 | $3 | $509 | 9.22% |
| PHILIP N. MCKELVEY3 | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $147 | $0 | $147 | 2.66% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $400 | $6 | $406 | 10.98% |
| PHILIP N. MCKELVEY3 | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $113 | $0 | $113 | 3.05% |
| PHILIP N. MCKELVEY3 | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 1.95% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 1.30% |
| PHILIP N. MCKELVEY3 | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 2.32% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 1.52% |
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 | 211 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 312 | $1.6M |
| Dental | DELTA DENTAL OF INDIANA | 315 | $99K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 312 | $1.6M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 196 | $71K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 196 | $71K |
| Prescription drug | ANTHEM INSURANCE COMPANIES, INC. | 312 | $1.6M |
| Other(5 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 196 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.