| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M J INSURANCE INC.3 Filed as: M-J INSURANCE | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | AMERICAN UNITED LIFE INSURANCE COMPANY | $31K | — | $31K | 15.00% |
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL BENEFIT SOLUTIONS LLC | 4133 MERCHANT DR STE 4 NEWBURGH, IN 47630 | HEALTH RESOURCES, INC. | $12K | — | $12K | 7.50% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $170 | $189 | 13.60% |
| M J INSURANCE INC.3 Filed as: M-J INSURANCE, INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.86% |
| PHILIP N. MCKELVEY3 Filed as: PHILIP MCKELVEY | 600 W LOVELAND AVE, STE 5A LOVELAND, OH 45140 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.14% |
| JAMES J. PASSAS3 | 125 SPRINGHURST CIRCLE LAKE MARY, FL 32746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.14% |
No Schedule C service providers reported on this filing.
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 | 506 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HEALTH RESOURCES, INC. | 359 | $156K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 507 | $206K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 507 | $206K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 507 | $206K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 507 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.