| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 6714 POINTE INVERNESS WAY STE 100 FORT WAYNE, IN 46804 | ANTHEM INSURANCE COMPANIES, INC. | $3K | — | $3K | 0.51% |
| STEPPING STONES UNLIMITED, INC.3 Filed as: STEPPING STONES UNLIMITED, INC | 1220 6TH AVE DAYTON, KY 41074 | TRANSAMERICA LIFE INSURANCE COMPANY | $42K | — | $42K | 12.24% |
| LARS HAAPALA3 | 1220 6TH AVE DAYTON, KY 41074 | TRANSAMERICA LIFE INSURANCE COMPANY | $8K | — | $8K | 2.41% |
| HYLANT GROUP INC3 | 1505 JEFFERSON AVE TOLEDO, OH 436045722 | TRANSAMERICA LIFE INSURANCE COMPANY | $6K | — | $6K | 1.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 650 E. CARMEL DR. STE 400 CARMEL, IN 46032 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 0.62% |
| FOUNDATION RISK PARTNERS CORP3 | 2125 YGNACIO VALLEY RD. STE 200 WALNUT CREEK, CA 94598 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 0.56% |
| AMERICAN INSURNET AGENCY INC3 | 644 LINN STREET #430 CINCINNATI, OH 45203 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 0.48% |
| 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 | $17 | — | $17 | 0.01% |
| DANE PAPE3 Filed as: DANE A PAPE | 115 EAST PLATT ST MAQUOKETA, IA 45263 | TRANSAMERICA LIFE INSURANCE COMPANY | $10 | — | $10 | 0.00% |
| HYLANT GROUP INC3 | 6714 POINTE INVERNESS WAY STE 100 FORT WAYNE, IN 46804 | ANTHEM LIFE INSURANCE COMPANY | $31K | — | $31K | 9.09% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | DELTA DENTAL OF INDIANA | $25K | — | $25K | 7.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INGENIORX, INC. | Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $897K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 NONE | Other fees; Insurance services Service code 23 | — | $342K |
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $323K |
| M&Z LLP NONE | Other fees Service code 99 | 101 N POLK ST MONROE, IN 46772 | $216K |
| HYLANT GROUP NONE | Insurance agents and brokers Service code 22 | 811 MADISON AVE TOLEDO, OH 43604 | $28K |
| FORVIS MAZARS, LLP NONE | Accounting (including auditing) Service code 10 | 111 E. WAYNE ST. SUITE 600 FORT WAYNE, IN 46802 | $11K |
| GALLAGHER BENEFIT SERVICES, INC | Other commissions; Non-monetary compensation; Insurance services Service code 23 | — | $1K |
| GALLAGHER BENEFIT SERVICES INC NONE | Insurance agents and brokers; Other commissions; Non-monetary compensation Service code 22 | 323 WEST LAKESIDE AVENUE SUITE 410 CLEVELAND, OH 44113 | $0 |
| INGENIORX, INC EIN 82-3062245 NONE | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) 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 | 1,628 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 48 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,677 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 1,043 | $567K |
| Dental | DELTA DENTAL OF INDIANA | 1,578 | $330K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 1,043 | $567K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 1,755 | $678K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 1,755 | $339K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 1,043 | $567K |
| Other | TRANSAMERICA LIFE INSURANCE COMPANY | 617 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,755 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.