| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M A DILTS AND ASSOCIATES INC3 Filed as: M.A. DILTS & ASSOCIATES, INC. | 526 E. 86TH AVE MERRILLVILLE, IN 464106213 | UNITEDHEALTHCARE INSURANCE COMPANY | $17K | — | $17K | 1.65% |
| M A DILTS AND ASSOCIATES INC3 | 526 E 86TH AVE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.78% |
| M A DILTS AND ASSOCIATES INC3 | 526 E 86TH AVE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 7.05% |
| M A DILTS AND ASSOCIATES INC3 | 526 E 86TH AVE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 15.00% |
| M A DILTS AND ASSOCIATES INC3 | 526 E 86TH AVE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Direct payment from the plan; Other services; Claims processing Service code 12 | — | $284K |
| M.A. DILTS & ASSOCIATES EIN 35-1845902 BROKER | Insurance agents and brokers; Other commissions Service code 22 | — | $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 | 288 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 601 | $1.1M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 351 | $193K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 351 | $153K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $73K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 601 | $1.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 601 | — |
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.