| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 462500418 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.31% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $153 | $3K | 14.53% |
| ONB INSURANCE GROUP INC.3 | 600 EAST 96TH STREET SUITE 400 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$11 | — | -$11 | -0.05% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $134 | $2K | 9.87% |
| ONB INSURANCE GROUP INC.3 | 600 EAST 96TH STREET SUITE 400 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$8 | — | -$8 | -0.05% |
| BRIAN WHITE3 Filed as: BRIAN C MOLDT | 11711 NORTH MERIDIAN STREET SUITE 350 CARMEL, IN 46032 | AMERICAN UNITED LIFE INSURANCE COMPANY | $2K | — | $2K | 13.56% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $113 | $1K | 10.89% |
| ONB INSURANCE GROUP INC.3 | 600 EAST 96TH STREET SUITE 400 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$7 | — | -$7 | -0.05% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $267 | $42 | $309 | 11.56% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 187 | $55K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 187 | $55K |
| Life insurance(3 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 140 | $30K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $17K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $20K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 140 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.