| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SYCAMORE INSURANCE ASSOCIATES, LLC3 Filed as: SYCAMORE INS. ASSOCIATION | 999 OHIO STREET TERRE HAUTE, IN 47807 | ANTHEM LIFE INSURANCE COMPANY | $33K | $0 | $33K | 3.68% |
| SYCAMORE INSURANCE ASSOCIATES, LLC3 Filed as: SYCAMORE INSURANCE ASSOCIATES | 999 OHIO STREET TERRE HAUTE, IN 47807 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 10.61% |
| HORIZON PLANNING GROUP3 | 9000 KEYSTONE CROSS INDIANAPOLIS, IN 46240 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8 | $0 | $8 | 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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 95 | $96K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 95 | $96K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 123 | $997K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 95 | $96K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 95 | $96K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 123 | $901K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.