| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | THE GUARDIAN LIFE INSURANCE COMPANY 0F AMERICA | $40K | $10K | $50K | 9.88% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 462500435 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $54K | — | $54K | 17.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24K | — | $24K | 17.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24K | — | $24K | 17.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 17.00% |
| MCKELVEY, PHILIP, NEILL3 | 600 WEST LOVELAND AVE SUITE 5A LOVELAND, OH 45140 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.90% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $270 | — | $270 | 0.97% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WIILIS H. GLAROS | 222 INDIANAPOLIS BOULEVARD SUITE 203 SCHERERVILLE, IN 46375 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $251 | — | $251 | 0.91% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | ANTHEM INSURANCE COMPANIES, INC. | — | $1K | $1K | 10.33% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $770 | — | $770 | 16.99% |
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 | 819 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 825 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY 0F AMERICA | 496 | $506K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY 0F AMERICA | 1,034 | $517K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 1,043 | $487K |
| Short-term disability(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 681 | $486K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 681 | $362K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 681 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,043 | — |
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.