| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS INC. | 925 WABASH AVENUE SUITE 200 TERRE HAUTE, IN 478073229 | UNITEDHEALTHCARE INSURANCE COMPANY | $17K | — | $17K | 3.15% |
| ONB INSURANCE GROUP INC.3 Filed as: ONB INSURANCE GROUP INC | P.O. BOX 80159 INDIANAPOLIS, IN 462800159 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $12K | $12K | 2.26% |
| ONI RISK PARTNERS INC3 Filed as: ONI RISK PARTNERS INC. | 1111 CHESTNUT HILLS PARKWAY FORT WAYNE, IN 46814 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $4K | $11K | 15.22% |
| KEVIN M VERST3 Filed as: KEVIN M. VERST | 4573 IRONWOOD LANE TERRE HAUTE, IN 47802 | AFLAC | $4K | $210 | $4K | 9.50% |
| JODIE HAMBLEN3 | 2488 EAST COLONIAL AVENUE TERRE HAUTE, IN 47805 | AFLAC | $4K | $223 | $4K | 9.34% |
| ROBERT W BURGETT3 Filed as: ROBERT W. BURGETT | 2601 FORTUNE CIRCLE EAST SUITE 103A INDIANAPOLIS, IN 46241 | AFLAC | $1K | $87 | $1K | 3.22% |
| WILLIAM RICHARD ELDEN3 | 400 WABASH AVENUE SUITE 10B TERRE HAUTE, IN 47807 | AFLAC | $1K | $87 | $1K | 2.72% |
| WILLIAM RICHARD ELDEN3 | 400 WABASH AVENUE SUITE B10 TERRE HAUTE, IN 47807 | AFLAC | $496 | — | $496 | 1.15% |
| JAMES CHALOS3 | 400 WABASH AVENUE SUITE B10 TERRE HAUTE, IN 47807 | AFLAC | $387 | — | $387 | 0.90% |
| JAMES CHALOS3 | 2935 NORTH 11TH STREET TERRE HAUTE, IN 47804 | AFLAC | $214 | — | $214 | 0.50% |
| NAVILLE & ASSOCIATES3 | 14220 OVERBROOK DRIVE CARMEL, IN 46074 | AFLAC | $119 | — | $119 | 0.28% |
| LARRY P WYNDHAM3 Filed as: LARRY P. WYNDHAM | 55 SOUTH FOREST AVENUE BRAZIL, IN 47834 | AFLAC | $68 | — | $68 | 0.16% |
| PETER J EMMERT3 Filed as: PETER J. EMMERT | 1048 WEST 17TH STREET BLOOMINGTON, IN 47404 | AFLAC | $25 | — | $25 | 0.06% |
| LYNN M STEPPE3 Filed as: LYNN M. STEPPE | 1208 NORTH FARRIER STREET TERRE HAUTE, IN 47803 | AFLAC | $13 | — | $13 | 0.03% |
| LLOYD W HUGHES3 Filed as: LLOYD W. HUGHES | 3775 NORTH US52 LEBANON, IN 46052 | AFLAC | $12 | — | $12 | 0.03% |
| MATTHEW A COOK3 Filed as: MATTHEW A. COOK | 10069 BENT TREE LANE FISHERS, IN 46037 | AFLAC | $9 | — | $9 | 0.02% |
| MARK A WOJDA3 | 631 GREENFORD TRAIL WEST CARMEL, IN 46032 | AFLAC | $8 | — | $8 | 0.02% |
| JAMES A BURRESS3 | 6418 FAYBOROUGH COURT DUBLIN, OH 43016 | AFLAC | $8 | — | $8 | 0.02% |
| KEVIN F WARD3 Filed as: KEVIN F. WARD | 12632 DOUBLE EAGLE DRIVE CARMEL, IN 46033 | AFLAC | $5 | — | $5 | 0.01% |
| JENNIFER L MITCHEN3 Filed as: JENNIFER L. MITCHEN | 9247 NORTH MERIDIAN STREET SUITE 205 INDIANAPOLIS, IN 46260 | AFLAC | $4 | — | $4 | 0.01% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $4 | — | $4 | 0.01% |
| JOHN T CLANCY3 Filed as: JOHN T. CLANCY | 4025 PETE DYE BOULEVARD CARMEL, IN 46033 | AFLAC | $4 | — | $4 | 0.01% |
| JOHN D TYLER3 Filed as: JOHN D. TYLER | 130 DUCK HAWK HIGHWAY MARIETTA, SC 29661 | AFLAC | $3 | — | $3 | 0.01% |
| PETER J EMMERT3 Filed as: PETER J. EMMERT | 2601 FORTUNE CIRCLE EAST SUITE 103A INDIANAPOLIS, IN 46241 | AFLAC | $3 | — | $3 | 0.01% |
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 | 176 | 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) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 127 | $537K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $70K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $70K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $70K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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."
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.