| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHELSEY DREIBELBIS3 | 629 CHARNWOOD PARKWAY BEEH GROVE, IN 46107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60K | $11K | $71K | 14.23% |
| B & B INSURANCE SOLUTIONS INC3 Filed as: B AND B INSURANCE SOLUTIONS, INC. | 12002 SW 128TH COURT MIAMI, FL 33186 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25K | $19K | $44K | 8.74% |
| JENNIFER JOY STARR3 Filed as: JENNIFER JOY STARR AND OTHER AGENTS | 1222 B PARADISE WAY NORTH DRIVE GREENWOOD, IN 46143 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24K | $2K | $26K | 5.26% |
| DAVID W OTTINGER3 Filed as: DAVID W. OTTINGER | 111 CURRY HILL ROAD LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15K | $3K | $18K | 3.62% |
| BRANDON MARCELLO CENTO3 | 17362 DOVEHOUSE LANE WESTFIELD, IN 46074 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $5K | $17K | 3.48% |
| MARY DAUGHERTY3 | 7625 STAR GAZING LANE KNOXVILLE, TN 37938 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $4K | $11K | 2.25% |
| HOWARD HOROWITZ3 Filed as: HOWARD J. HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 1.53% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD, SUITE 225 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $0 | $17K | 4.82% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 4.34% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONLON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.84% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24K | $1K | $25K | 28.92% |
| ENROLLEASE3 Filed as: FIRST PERSON BENEFIT ADVISORS | 9000 KEYSTONE CROSSING, SUITE 910 INDIANAPOLIS, IN 46240 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$889 | $0 | -$889 | -1.03% |
| ELIZABETH LOUISE FENDER3 | 335 SOUTH EMERSON AVENUE INDIANAPOLIS, IN 46219 | THE PAUL REVERE LIFE INSURANCE COMPANY | $6 | $0 | $6 | 2.18% |
| BRANDON MARCELLO CENTO3 | 17362 DOVEHOUSE LANE WESTFIELD, IN 46074 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 1.09% |
| GARY A INERSON3 Filed as: GARY A. INERSON | 12576 BLUE HOLLY DRIVE NOBLESVILLE, IN 46060 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 1.09% |
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 | 564 | 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) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 425 | $500K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 487 | $87K |
| Life insurance(4 contracts, 4 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 564 | $941K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 564 | $355K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 564 | $355K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 564 | $855K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 564 | — |
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.