| 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 AVENUE MERRILLVILLE, IN 46410 | UNITED HEALTHCARE INSURANCE COMPANY | $19K | — | $19K | 2.78% |
| M A DILTS AND ASSOCIATES INC3 Filed as: M.A. DILTS & ASSOCIATES | 526 E. 86TH AVENUE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 5.44% |
| M A DILTS AND ASSOCIATES INC3 Filed as: M.A. DILTS & ASSOCIATES INC | 526 E. 86TH AVENUE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 14.93% |
| M A DILTS AND ASSOCIATES INC3 Filed as: M.A. DILTS & ASSSOCIATES | 526 E. 86TH AVENUE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE | $5K | — | $5K | 9.63% |
| M A DILTS AND ASSOCIATES INC3 Filed as: M.A. DILTS & ASSOCIATES INC | 526 E. 86TH AVENUE MERRILLVILLE, IN 46410 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $270K |
| M.A. DILTS & ASSOCIATES INC EIN 35-1845902 BROKER | Insurance agents and brokers; Other commissions Service code 22 | — | $0 |
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 | 324 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 690 | $684K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $181K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $127K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE | 327 | $68K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 690 | $684K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 690 | — |
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.