| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED BENEFIT ADVISORS LLC3 | 20 N. WACKER DRIVE, SUITE 500 CHICAGO, IN 606062806 | SUN LIFE ASSURANCE COMPANY OF CANADA | $45K | — | $45K | 1.50% |
| LOCASCIO HADDEN & DENNIS LLC3 Filed as: LOCASCIO, HADDEN & DENNIS | 250 WEST 96TH ST., SUITE 350 INDIANAPOLIS, IN 46260 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $30K | $30K | 1.00% |
| UMR, INC.3 Filed as: UMR INC | 115 W. WAUSAU AVE. WAUSAU, WI 544012875 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $16K | $16K | 0.54% |
| LOCASCIO HADDEN & DENNIS LLC3 Filed as: LOCASCIO, HADDEN & DENNIS | 250 WEST 96TH ST., SUITE 350 INDIANAPOLIS, IN 462601317 | VISION SERVICE PLAN | $14K | — | $14K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARATHON HEALTH, LLC EIN 26-0103977 NONE | Other services; Direct payment from the plan Service code 49 | — | $1.1M |
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $975K |
| HARTFORD LIFE AND ACCIDENT EIN 06-0838648 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $389K |
| JODY HIRST NONE | Other services; Direct payment from the plan Service code 49 | 394 VENTANA CT INDIANAPOLIS, IN 46290 | $78K |
| THE VISIBILITY COMPANY (PROPEL) EIN 22-3873674 NONE | Other services; Direct payment from the plan Service code 49 | — | $43K |
| CVS PHARMACY EIN 05-0340626 NONE | Claims processing; Contract Administrator; Other services; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $41K |
| TOWERS WATSON EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $40K |
| FORVIS MAZARS, LLP EIN 44-0160260 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $31K |
| QUIZZIFY, LLC EIN 46-5165032 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $28K |
| AMERICAN UNITED LIFE INSURANCE EIN 35-0145825 AFFILIATED ORG | Contract Administrator; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $15K |
| ST. VINCENT HOSPITAL EIN 35-0869066 NONE | Direct payment from the plan; Other fees Service code 50 | — | $10K |
| EMPLOYERS HEALTH COALITION EIN 34-1403820 NONE | Other services; Direct payment from the plan Service code 49 | — | $9K |
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 | 2,555 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 308 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,863 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 5,390 | $1.8M |
| Vision | VISION SERVICE PLAN | 2,104 | $277K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,858 | $1.6M |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,555 | $1.3M |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,555 | $1.3M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,156 | $3.0M |
| Other(3 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,858 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,390 | — |
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.