| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PHP TPA SERVICES3 Filed as: PHP OF NORTHERN INDIANA, INC | 8101 W. JEFFERSON BLVD FORT WAYNE, IN 468044163 | PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA INC | $31K | — | $31K | 2.44% |
| PLATINUM BENEFIT CONSULTING GROUP3 | 4215 EDISON LAKES PKWY STE 200 MISHAWAKA, IN 465451425 | PRINCIPAL LIFE INSURANCE COMPANY | $18K | $10K | $28K | 10.21% |
| PLATINUM BENEFIT CONSULTING GROUP3 | 4215 EDISON LAKES PKWY STE 200 MISHAWAKA, IN 465451425 | VISION SERVICE PLAN | $1K | — | $1K | 5.03% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 422 | $276K |
| Vision | VISION SERVICE PLAN | 177 | $25K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 422 | $276K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 422 | $276K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 422 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.