| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | ANTHEM INSURANCE COMPANIES, INC. | $2K | $36 | $2K | 0.33% |
| HYLANT GROUP INC3 | 6714 POINTE INVERNESS WAY STE 100 FORT WAYNE, IN 46804 | ANTHEM INSURANCE COMPANIES, INC. | $939 | — | $939 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | ANTHEM LIFE INSURANCE COMPANY | $23K | — | $23K | 7.51% |
| HYLANT GROUP INC3 | 6714 POINTE INVERNESS WAY STE 100 FORT WAYNE, IN 46804 | ANTHEM LIFE INSURANCE COMPANY | $10K | — | $10K | 3.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF INDIANA | $10K | — | $10K | 3.39% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | DELTA DENTAL OF INDIANA | $10K | — | $10K | 3.15% |
| LARS HAAPALA3 | 1220 6TH AVE DAYTON, KY 41074 | TRANSAMERICA LIFE INSURANCE COMPANY | $21K | — | $21K | 11.76% |
| STEPPING STONES UNLIMITED, INC.3 Filed as: STEPPING STONES UNLIMITED, INC | 1220 6TH AVE DAYTON, KY 41074 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | — | $7K | 4.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 650 E. CARMEL DR. STE 400 CARMEL, IN 46032 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 2.12% |
| AMERICAN INSURNET AGENCY INC3 | 644 LINN STREET #430 CINCINNATI, OH 45203 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 1.70% |
| FOUNDATION RISK PARTNERS CORP3 | 2125 YGNACIO VALLEY RD. STE 200 WALNUT CREEK, CA 94598 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 0.72% |
| INTEGRO INSURANCE BROKERS3 Filed as: EPIC INSURANCE SOLUTIONS LLC | FIFTH THIRD INSURANCE AGENCY 38 FOUNTAIN SQ PLZ MD1090GB MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $657K |
| INGENIORX, INC. | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $462K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 NONE | Insurance services; Other fees Service code 23 | — | $314K |
| M&Z LLP NONE | Other fees Service code 99 | 101 N POLK ST MONROE, IN 46772 | $255K |
| HYLANT GROUP NONE | Insurance agents and brokers Service code 22 | 811 MADISON AVE TOLEDO, OH 43604 | $59K |
| FORVIS, LLP NONE | Accounting (including auditing) Service code 10 | 111 E. WAYNE ST. SUITE 600 FORT WAYNE, IN 46802 | $17K |
| GALLAGHER BENEFIT SERVICES, INC. | Insurance services; Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees Service code 23 | — | $10K |
| CARELONRX, INC EIN 82-3062245 NONE | Claims processing; Other services; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $6K |
| GALLAGHER BENEFIT SERVICES INC NONE | Other commissions; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | $0 |
| INGENIORX, INC EIN 82-3062245 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing 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 | 1,514 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,568 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 1,000 | $512K |
| Dental | DELTA DENTAL OF INDIANA | 1,524 | $304K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 1,000 | $512K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 1,559 | $490K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 1,559 | $311K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 1,000 | $512K |
| Other | TRANSAMERICA LIFE INSURANCE COMPANY | 225 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,559 | — |
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.