| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KIRK A PACATTE3 | 120 EXECUTIVE DRIVE HIGHLAND, IL 62249 | STANDARD INSURANCE COMPANY | $147K | — | $147K | 23.00% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY AUSTIN, TX 78746 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 NONE | Direct payment from the plan; Legal; Claims processing Service code 12 | — | $3.1M |
| E-PLAN EIN 20-3720767 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $925K |
| AMERICAN HEALTH HOLDING INC EIN 31-1368946 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $478K |
| INDUSTRY FUNDS MANAGEMENT (US), LLC EIN 98-0569684 NONE | Investment management fees paid indirectly by plan; Investment management; Foreign entity (e.g., an agent or broker, bank, insurance company, etc. not operating within jurisdictional boundaries of the United States) Service code 28 | — | $279K |
| SMITH GRAHAM & CO INVESTMENT ADVIS EIN 76-0301817 NONE | Investment management; Investment management fees paid directly by plan; Non-monetary compensation Service code 28 | — | $269K |
| BEACH POINT LOAN FUND LP EIN 80-0242162 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $240K |
| DELTA DENTAL EIN 35-1545647 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $226K |
| DONALD M. EDWARDS EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $108K |
| ULLICO INVESTMENT ADVISORS, INC EIN 52-6435649 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $89K |
| SOMER TAYLOR EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| UNITED ACTUARIAL SERVICES EIN 35-2156428 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $82K |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $78K |
| WRIGHT, SHAGLEY, & LOWERY, PC EIN 20-8333939 NONE | Direct payment from the plan; Legal Service code 29 | — | $75K |
| MELISSA D. WADE EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| MICHAEL EDWARDS EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| TIMOTHY PATRICK EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| LYNN THOMPSON EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| FIRST FINANCIAL BANK EIN 35-0704860 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $64K |
| ADRIENNE BROWN EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| LISA WHITE EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| STEPHANIE MARTIN EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| SHERRY ALLEN EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| ASB CAPITAL MANAGEMENT, INC. EIN 80-0618452 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $58K |
| RAMONA L. CRANDELL EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| STACY L. NGUYEN EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| BRIANNA R. STEWART EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| NATIONAL INVESTMENT SERVICES EIN 80-0169636 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $55K |
| NORA LEWELLYN-KENNEDY EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| GEORGE D. NAILOR EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| JOSH A. STOUT EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $51K |
| KYLE A. COLETTI EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| ROBERT A. HELLER EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $48K |
| CANDIE S. ALLEN EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| JANETTA E. ENGLAND EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $47K |
| JESSICA J. THOME EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| JOE D. FAUGHT EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $44K |
| KAITLIN D. BROWN EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $42K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $40K |
| HARTFORD LIFE INSURANCE CO. EIN 06-0974148 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $39K |
| SHELLEY LUFT EIN 35-0923209 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $36K |
| KELSEY L. EMMONS EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $35K |
| REBECCA L. MACE EIN 35-0923209 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $31K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $26K |
| JEWETT PRINTING NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 219 W. MAIN ST. FARMERSBURG, IN 47850 | $26K |
| L.M. HENDERSON & COMPANY, LLP EIN 20-5520612 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $20K |
| PHYSICIANS REVIEW NETWORK EIN 86-0801826 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $15K |
| SACKRIDER & COMPANY, INC. EIN 35-1327464 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| FILLENWARTH DENNERLINE GROTH & TOWE EIN 26-2311312 NONE | Direct payment from the plan; Legal Service code 29 | — | $12K |
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 | 7,216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,897 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 8,915 | $639K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 8,006 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,915 | — |
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.