| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC5 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | COMPANION LIFE | $58K | — | $58K | 5.00% |
| KEY BENEFIT ADMINISTRATORS, INC5 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | NATION UNION FIRE INSURANCE COMPANY OF PITTSBURG | $38K | — | $38K | 10.00% |
| CLIPPINGER FINANCIAL GROUP LLC3 | 415 CROSSLAKE DRIVE STE B EVANSVILLE, IN 477125020 | VISION SERVICE PLAN | $4K | — | $4K | 1.94% |
| CLIPPINGER FINANCIAL GROUP LLC3 | 415 CROSSLAKE DR STE A EVANSVILLE, IN 47715 | HEALTH RESOURCES, INC. | $33K | — | $33K | 50.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $482K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-0248379 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $119K |
| ENCORE EIN 35-2067373 NONE | Contract Administrator Service code 13 | 7224 SOLUTION CENTER CHICAGO, IL 60677 | $99K |
| CIGNA CORP EIN 06-0303370 NONE | Contract Administrator Service code 13 | P.O. BOX 645014 CINCINNATI, OH 45264 | $81K |
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 | 1,796 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,812 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE | 1,796 | $1.2M |
| Dental | HEALTH RESOURCES, INC. | 1,780 | $65K |
| Vision | VISION SERVICE PLAN | 1,481 | $231K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE | 1,796 | $1.2M |
| Other | NATION UNION FIRE INSURANCE COMPANY OF PITTSBURG | 1,796 | $385K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,796 | — |
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.