| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGANT ST 1400 SOUTH BEND, IN 46601 | SYMETRA LIFE INSURANCE COMPANY | $64K | $22K | $86K | 12.26% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 S. MAIN ST 400 SOUTH BEND, IN 46601 | DELTA DENTAL OF INDIANA | $31K | $466 | $31K | 8.65% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 333 E JEFFERSON ST PLYMOUTH, IN 46563 | ANTHEM INSURACE COMPANIES, INC | $3K | — | $3K | 4.82% |
| 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 | $311 | $3K | 16.74% |
| 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 | $309 | $3K | 17.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| L.M. HENDERSON & COMPANY, LLP EIN 20-5520612 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| CONCORD ADVISORY GROUP EIN 22-3039644 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $5K |
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 | 3,034 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,034 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 768 | $363K |
| Vision | ANTHEM INSURACE COMPANIES, INC | 481 | $66K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 1,662 | $705K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 1,662 | $705K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 1,662 | $705K |
| Other(3 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,662 | $738K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,662 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.