| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: FIRST PERSON INC | 9000 KEYSTONE CROSSING INDIANAPOLIS, IN 46240 | DELTA DENTAL OF INDIANA | $280 | — | $280 | 0.02% |
| ENROLLEASE3 Filed as: FIRST PERSON INC | 9000 KEYSTONE CROSSING SUITE 910 INDIANAPOLIS, IN 46240 | ANTHEM INSURANCE COMPANIES, INC. | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 SERVICE PROVIDER | Other services; Claims processing; Float revenue; Contract Administrator; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 7501 EAGLE CREST BLVD EVANSVILLE, IN 477158151 | $2.3M |
| ST. VINCENT SERVICE PROVIDER | Direct payment from the plan Service code 50 | 10330 N MERIDIAN ST SUITE 430 INDIANAPOLIS, IN 46290 | $708K |
| HARDIN MEMORIAL HOSPITAL SERVICE PROVIDER | Direct payment from the plan Service code 50 | PO BOX 2289 ELIZABETHTOWN, KY 42702 | $241K |
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 | 2,472 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,510 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 6,536 | $1.7M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 1,950 | $311K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 2,222 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,536 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.