| 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 | $46K | — | $46K | 1.70% |
| UMR, INC.3 Filed as: UMR INC | 115 W. WAUSAU AVE. WAUSAU, WI 544012875 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $13K | $13K | 0.48% |
| LOCASCIO HADDEN & DENNIS LLC3 Filed as: LOCASCIO, HADDEN & DENNIS | 250 W 96TH ST STE 350 INDIANAPOLIS, IN 46260 | DELTA DENTAL OF INDIANA | $2K | — | $2K | 0.14% |
| 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 | — | $962K |
| HARTFORD LIFE AND ACCIDENT EIN 06-0838648 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $383K |
| JODY HIRST NONE | Direct payment from the plan; Other services Service code 49 | 394 VENTANA CT INDIANAPOLIS, IN 46290 | $88K |
| CVS PHARMACY EIN 05-0340626 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $56K |
| THE VISIBILITY COMPANY (PROPEL) EIN 22-3873674 NONE | Other services; Direct payment from the plan Service code 49 | — | $45K |
| TOWERS WATSON EIN 53-0181291 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $42K |
| FORVIS MAZARS, LLP EIN 44-0160260 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $32K |
| QUIZZIFY, LLC EIN 46-5165032 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $28K |
| AMERICAN UNITED LIFE INSURANCE EIN 35-0145825 AFFILIATED ORG | Contract Administrator; Participant communication; Direct payment from the plan; Claims processing Service code 12 | — | $14K |
| ST. VINCENT HOSPITAL EIN 35-0869066 NONE | Other fees; Direct payment from the plan Service code 50 | — | $10K |
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 | 2,400 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 309 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,709 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 5,074 | $1.8M |
| Vision | VISION SERVICE PLAN | 2,036 | $278K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,695 | $1.7M |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,401 | $1.3M |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,401 | $1.3M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,080 | $2.7M |
| Other(3 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 2,695 | $3.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,074 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.