| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GERMAN AMERICAN INSURANCE, INC.3 Filed as: GERMAN AMERICAN INSURANCE INC | PO BOX 1008 JASPER, IN 47547 | PARAMOUNT DENTAL | $5K | — | $5K | 10.00% |
| GERMAN AMERICAN INSURANCE, INC.3 Filed as: GERMAN AMERICAN INSURANCE INC | 246 3RD AVENUE JASPER, IN 47546 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| JAMES R STROSNIDER3 | 704 SE 11TH ST WASHINGTON, IN 47501 | AFLAC | $591 | — | $591 | 2.59% |
| ROBERT D WAKE3 | PO BOX 87 WASHINGTON, IN 47501 | AFLAC | $591 | — | $591 | 2.59% |
| LAWRENCE D. LONG3 Filed as: LAWRENCE D LONG | 144 PINEVIEW DRIVE VINCENNES, IN 47591 | AFLAC | $369 | — | $369 | 1.62% |
| LAUREL A SEGER3 | 902A MAIN ST JASPER, IN 47546 | AFLAC | $266 | — | $266 | 1.17% |
| CHRIS A GEHLHAUSEN3 | 873 3RD AVENUE JASPER, IN 47546 | AFLAC | $189 | — | $189 | 0.83% |
| MICHAEL MOORE3 | 1705 HONEYBROOK LANE SAINT LOUIS, MO 63138 | AFLAC | $171 | — | $171 | 0.75% |
| BRANDEE L JUSTUS3 | 5700 VICTORIA BLUFFS DR NEWBURGH, IN 47630 | AFLAC | $115 | — | $115 | 0.50% |
| HASTINGS WILLIAMS AGENCY, INC.3 Filed as: HASTINGS WILLIAMS AGENCY | 4634 E 400 S MONTGOMERY, IN 47558 | AFLAC | $81 | — | $81 | 0.35% |
| ROBIN FROMME3 | 1001 EISENHOWER AVE JASPER, IN 47546 | AFLAC | $58 | — | $58 | 0.25% |
| JARREN BELT3 | 514 PLAZA ONE OFFICE CENTER SUITE 110 EARTH CITY, MO 63045 | AFLAC | $48 | — | $48 | 0.21% |
| BRADLEY T VANDEGRIFFE3 | 914 CREEKMOOR DR RAYMORE, MO 64083 | AFLAC | $35 | — | $35 | 0.15% |
| JEREMY BROCKMAN3 Filed as: JEREMY LEE BROCKMAN | 324 FAIRWAY BLVD PANAMA CITY BEACH, FL 32407 | AFLAC | $33 | — | $33 | 0.14% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $31 | — | $31 | 0.14% |
| LLOYD W HUGHES3 | 3775 N STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $26 | — | $26 | 0.11% |
| SHARON R LUCARELLI3 | 12752 BENNINGTON COMMON LANE SAINT LOUIS, MO 63146 | AFLAC | $22 | — | $22 | 0.10% |
| JAMES M FLETCHER3 | 7325 CLUBHOUSE DR FORT WAYNE, IN 46835 | AFLAC | $18 | — | $18 | 0.08% |
| JEREMY GEISLER INC3 | 1765 CLARKSON RD STE 301 CHESTERFIELD, MO 63017 | AFLAC | $16 | — | $16 | 0.07% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $12 | — | $12 | 0.05% |
| KORY L ALBRECHT3 | 5 ANNA DR SAINT CHARLES, MO 63304 | AFLAC | $10 | — | $10 | 0.04% |
| BRADLEY K HARRISON3 | 1530 RAX CT JEFFERSON CITY, MO 65019 | AFLAC | $10 | — | $10 | 0.04% |
| MATTHEW A COOK3 | 10069 BENT TREE LN FISHERS, IN 46037 | AFLAC | $8 | — | $8 | 0.04% |
| JOHN TYLER & ASSOCIATES3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $8 | — | $8 | 0.04% |
| MARSHA S TALLEY3 | 4295 W PEBBLE DR JASPER, IN 47546 | AFLAC | $7 | — | $7 | 0.03% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $6 | — | $6 | 0.03% |
| MARK A WOJDA3 | 16258 DOGWOOD LANE PLYMOUTH, IN 46563 | AFLAC | $6 | — | $6 | 0.03% |
| GEISLER INCORPORATED3 | 1795 CLARKSON RD STE 301 CHESTERFIELD, MO 63017 | AFLAC | $5 | — | $5 | 0.02% |
| KEVIN F WARD3 | 12632 DOUBLE EAGLE DR CARMEL, IN 46033 | AFLAC | $4 | — | $4 | 0.02% |
| AMY N GEHLHAUSEN3 Filed as: AMY L GEHLHAUSEN | 3115 HOWARD DR JASPER, IN 47546 | AFLAC | $3 | — | $3 | 0.01% |
| TYSON C FUNK3 | 917 CROWN POINTE TERRACE CT WILDWOOD, MO 63021 | AFLAC | $3 | — | $3 | 0.01% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE CT PLAINFILED, IN 46188 | AFLAC | $2 | — | $2 | 0.01% |
| AUSTIN J PETERSON3 | 11116 AURORA AVE URBANDALE, IA 50322 | AFLAC | $2 | — | $2 | 0.01% |
| NATHAN L HARRISON3 | 5301 E VISTA RICA ST PARADISE VALLEY, AZ 85253 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN D NEUNER3 | 7651 E HIGHWAY WW COLUMBIA, MO 65201 | AFLAC | $1 | — | $1 | 0.00% |
| DAYTON LLC3 | 5445 DTC PKWY STE 1036 GREENWOOD VILLAGE, CO 80111 | AFLAC | $1 | — | $1 | 0.00% |
| JOHN A BACON3 | 30837 SPRING VALLEY RD PAOLA, KS 66071 | AFLAC | $1 | — | $1 | 0.00% |
| JEFFREY HIMMELRICK3 | 2215 W A ST NORTH PLATTE, NE 69101 | AFLAC | $1 | — | $1 | 0.00% |
| GERMAN AMERICAN INSURANCE, INC.3 Filed as: GERMAN AMERICAN INSURANCE INC | PO BOX 1008 JASPER, IN 47547 | VISION SERVICE PLAN | $831 | — | $831 | 6.12% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA EASE CENTRAL | 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $56 | — | $56 | 0.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCESS RE EIN 22-2945293 REINSURANCE PREMIUMS | Insurance brokerage commissions and fees Service code 53 | — | $346K |
| UNIFIED GROUP SERVICES EIN 35-1973675 ADMIN | Contract Administrator; Claims processing Service code 12 | — | $38K |
| GERMAN AMERICAN INSURANCE EIN 35-1985025 BROKER FEES | Insurance brokerage commissions and fees Service code 53 | — | $24K |
| TOKIO MARINE HCC EIN 25-1118523 ORGAN TRANSPLANT PREM | Other fees Service code 99 | — | $12K |
| ENCORE COMBINED EIN 35-2067373 PREF PROVIDER ORG FEES | Other fees Service code 99 | — | $7K |
| SERVUSCARE EIN 86-1329911 UTILIZATION REVIEW | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $3K |
| ACTIVE HEALTH MANAGEMENT EIN 52-2182411 CARE ENGINE FEES | Other fees Service code 99 | — | $2K |
| FIRST HEALTH VIA ENCORE HN EIN 35-2067373 PREF PROVIDER ORG FEES | Other fees Service code 99 | — | $2K |
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 | 215 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PARAMOUNT DENTAL | 162 | $51K |
| Vision | VISION SERVICE PLAN | 91 | $14K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 215 | $50K |
| Short-term disability | AFLAC | 23 | $23K |
| Long-term disability | AFLAC | 23 | $23K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 215 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.