| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC5 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46226 | AMERICAN FIDELITY ASSURANCE COMPANY | $24K | — | $24K | 5.00% |
| GERALD G. HARTMAN3 Filed as: GERALD HARTMAN | 1487 DAVID LANE BOISE, ID 83705 | AMERICAN FIDELITY ASSURANCE COMPANY | $12K | — | $12K | 2.50% |
| LYDIA C CLARK3 Filed as: LYDIA CLARK | 11882 PINE MEADOW CIR FISHERS, IN 46037 | DELTA DENTAL OF OHIO | $2K | — | $2K | 1.98% |
| INTERGRITY BENEFIT PARTNERS, INC3 | 11925 E 65TH ST STE 5 INDIANAPOLIS, IN 46235 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 6.00% |
| LYDIA CHRISTINE CLARK3 | 11925 E 65TH ST STE 5 INDIANAPOLIS, IN 46236 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTEGRITY BENEFIT PARTNERS EIN 46-1649549 NOT RELATED | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $97K |
| KEY BENEFIT ADMINISTRATORS, INC EIN 35-1450364 NOT RELATED | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | — | $61K |
| GREATWEST HEALTHCARE/CIGNA EIN 84-0467907 NOT RELATED | Claims processing; Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $52K |
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NOT RELATED | Claims processing; Contract Administrator; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $37K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 NOT RELATED | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing Service code 12 | — | $32K |
| GERALD HARTMAN EIN 50-1465943 NOT RELATED | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $6K |
| LYDIA CLARK | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | — | $3K |
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 | 387 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 387 | $78K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 376 | $24K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 360 | $10K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 203 | $471K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 360 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.