| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | PO BOX 11177 SOUTH BEND, IN 46634 | SYMETRA LIFE INSURANCE COMPANY | $68K | $14K | $82K | 12.14% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 S. MAIN ST 400 SOUTH BEND, IN 46601 | DELTA DENTAL OF INDIANA | $27K | — | $27K | 7.78% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | PO BOX 11177 SOUTH BEND, IN 46634 | SYMETRA LIFE INSURACE COMPANY | $21K | $4K | $26K | 13.28% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | PO BOX 11177 SOUTH BEND, IN 46634 | ANTHEM INSURACE COMPANIES, INC | — | $1K | $1K | 1.43% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 S. MAIN ST 400 SOUTH BEND, IN 46601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $151 | $3K | 15.89% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 S. MAIN ST 400 SOUTH BEND, IN 46601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $113 | $2K | 15.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NAMIC SERVICE CORPORATION, INC. EIN 35-1176317 RELATED PARTY | Other services Service code 49 | — | $252K |
| L.M. HENDERSON & COMPANY, LLP EIN 20-5520612 NONE | Accounting (including auditing) Service code 10 | — | $24K |
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 | 3,218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 72 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 794 | $352K |
| Vision | ANTHEM INSURACE COMPANIES, INC | 478 | $74K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,664 | $870K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 1,664 | $676K |
| Long-term disability(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,664 | $870K |
| Other(4 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,664 | $900K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,664 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.