| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: FIRST PERSON, INC. | 9000 KEYSTONE CROSSING #910 INDIANAPOLIS, IN 46240 | DELTA DENTAL OF INDIANA | — | $2K | $2K | 0.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 SERVICE PROVIDER | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees Service code 12 | 7501 EAGLE CREST BLVD EVANSVILLE, IN 477158151 | $3.0M |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | PO BOX 9089 FARMINGTON HILLS, MI 48333 | $106K |
| ST. VINCENT SERVICE PROVIDER | Direct payment from the plan Service code 50 | 10330 N MERIDIAN ST. SUITE 430 INDIANAPOLIS, IN 46290 | $71K |
| ALTERNATIVE HEALTH SOLUTIONS, LLC SERVICE PROVIDER | Direct payment from the plan Service code 50 | 2843 BROWNSBORO ROAD, SUITE 201 LOUISVILLE, KY 40206 | $36K |
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 | 2,737 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 6,992 | $1.7M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 2,764 | $1.5M |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 2,764 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,992 | — |
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.