| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ONI RISK PARTNERS INC | 925 WABASH AVENUE SUITE 200 TERRE HAUTE, IN 47807 | ANTHEM INSURANCE COMPANIES, INC. | $40K | — | $40K | 4.65% |
| ONB INSURANCE GROUP INC.3 Filed as: ONB INSURANCE GROUP INC | 600 E 96TH STREET SUITE 400 INDIANAPOLIS, IN 46280 | HEALTH RESOURCES, INC. | $4K | — | $4K | 10.00% |
| ONB INSURANCE GROUP INC.3 Filed as: ONB INSURANCE GROUP INC | 600 E 96TH STREET SUITE 400 INDIANAPOLIS, IN 46240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| ONB INSURANCE GROUP INC.3 Filed as: ONB INSURANCE GROUP INC | 600 E 96TH STREET SUITE 400 INDIANAPOLIS, IN 46240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $835 | — | $835 | 10.00% |
| ONI RISK PARTNERS INC | 925 WABASH AVENUE SUITE 200 TERRE HAUTE, IN 47807 | ANTHEM INSURANCE COMPANIES, INC. | $150 | — | $150 | 5.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 SERVICE PROVIDER | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Other services Service code 12 | 1351 WM HOWARD TAFT RD CINCINNATI, OH 45206 | $281K |
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 | 183 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 107 | $866K |
| Dental | HEALTH RESOURCES, INC. | 103 | $44K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 106 | $3K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $27K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $27K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.