| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 NORTH CLARK STREET CHICAO, IL 60654 | UNITED STATES FIRE INSURANCE COMPANY | $55K | — | $55K | 11.71% |
| LYNN KITSON3 | 58053 CRYSTAL SPRINGS DRIVE GOSHEN, IN 46528 | DELTA DENTAL OF INDIANA | $5K | — | $5K | 3.57% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 NORTH CLARK STREET CHICAGO, IL 60654 | AIG MEDICAL EXCESS | $6K | — | $6K | 10.00% |
| LYNN KITSON3 | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | VISION SERVICE PLAN | $2K | — | $2K | 4.09% |
| MWL3 | PO BOX 14607 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $528 | — | $528 | 2.67% |
| LYNN KITSON3 Filed as: LYNN MATTEI | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $274 | — | $274 | 1.38% |
| LYNN KITSON3 Filed as: LYNN MATTEI | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 12.01% |
| MWL3 | PO BOX 14607 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $499 | — | $499 | 2.60% |
| LYNN KITSON3 Filed as: LYNN MATTEI | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $791 | — | $791 | 11.99% |
| MWL3 | PO BOX 14607 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $176 | — | $176 | 2.67% |
| LYNN KITSON3 Filed as: LYNN MATTEI | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $737 | — | $737 | 12.01% |
| MWL3 | PO BOX 14607 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $160 | — | $160 | 2.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP ADMINISTRATORS, LTD. EIN 36-3381052 NONE | Claims processing Service code 12 | 915 NATIONAL PARKWAY SUITE F SCHAUMBURG, IL 60173 | $84K |
| MESIROW INSURANCE SERVICES EIN 36-3429604 NONE | Insurance agents and brokers Service code 22 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | $78K |
| CIGNA EIN 59-1031071 NONE | Other fees Service code 99 | PO BOX 645014 CINCINNATI, OH 45264 | $56K |
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 | 282 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 0 | $142K |
| Vision | VISION SERVICE PLAN | 0 | $40K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 350 | $20K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 303 | $6K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 350 | $19K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE COMPANY | 282 | $466K |
| Other(2 contracts, 2 carriers) | AIG MEDICAL EXCESS | 350 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.