| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC5 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | HCC LIFE INSURANCE | $34K | — | $34K | 10.00% |
| CLIPPINGER FINANCIAL GROUP LLC3 | 415 CROSSLAKE DR #A EVANSVILLE, IN 47715 | VISION SERVICE PLAN | $5K | — | $5K | 1.93% |
| CLIPPINGER FINANCIAL GROUP LLC | 415 CROSSLAKE DR #A EVANSVILLE, IN 47715 | HEALTH RESOURCES, INC. | $10K | — | $10K | 16.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC EIN 35-1450364 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $461K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $189K |
| CIGNA EIN 06-0303370 NONE | Contract Administrator Service code 13 | P.O. BOX 645014 CINCINNATI, OH 45264 | $104K |
| ENCORE EIN 35-2067373 NONE | Contract Administrator Service code 13 | 7224 SOLUTION CENTER CHICAGO, IL 60677 | $91K |
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 | 1,632 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,649 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RELIASTAR LIFE INSURACE | 1,632 | $1.2M |
| Dental | HEALTH RESOURCES, INC. | 0 | $61K |
| Vision | VISION SERVICE PLAN | 1,456 | $236K |
| Other | HCC LIFE INSURANCE | 1,632 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,632 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.