| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $9K | $46K | 16.48% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $14K | $28K | 10.06% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $8K | $33K | 25.08% |
| ENROLL X LLC3 | 548 CANTON RD WINTERSVILLE, OH 43953 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 8.12% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $506 | $3K | 6.46% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $2K | $3K | 5.69% |
| ENROLL X LLC3 | 548 CANTON RD WINTERSVILLE, OH 43953 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 13.91% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $292 | $3K | 10.47% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | METROPOLITAN LIFE INSURANCE COMPANY | $617 | $956 | $2K | 6.45% |
| ENROLL X LLC3 | 548 CANTON RD WINTERSVILLE, OH 43953 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 14.06% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $386 | $3K | 11.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | METROPOLITAN LIFE INSURANCE COMPANY | $661 | $1K | $2K | 8.19% |
| KEYSTONE INSURANCE & BENEFITS GROUP Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $377 | $5K | 25.92% |
| ENROLL X LLC3 | 548 CANTON RD WINTERSVILLE, OH 43953 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 20.43% |
| ENROLL X LLC3 | 548 CANTON RD WINTERSVILLE, OH 43953 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 46.53% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $228 | $4K | 44.51% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $219 | $3K | 39.18% |
| ENROLL X LLC3 | 548 CANTON RD WINTERSVILLE, OH 43953 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 36.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 ADMIN SERVICES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Contract Administrator; Other services; Non-monetary compensation; Claims processing; Insurance brokerage commissions and fees; Other commissions; Float revenue Service code 12 | — | $657K |
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 | 430 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 430 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $66K |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,045 | $412K |
| Vision(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,045 | $412K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,045 | $412K |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,045 | $412K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,045 | $412K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 752 | $1.1M |
| Other(4 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,045 | $481K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,045 | — |
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.