| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 460823430 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 6.62% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 46082 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $456 | $3K | 18.30% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 46082 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $400 | $2K | 13.68% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 46082 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $943 | $295 | $1K | 14.45% |
| BRIAN WHITE3 Filed as: BRIAN C MOLDT | 11711 NORTH MERIDIAN STREET SUITE 350 CARMEL, IN 46032 | AMERICAN UNITED LIFE INSURANCE COMPANY | $2K | — | $2K | 23.63% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 46082 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $405 | $76 | $481 | 11.89% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $35K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $35K |
| Life insurance(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 149 | $20K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 150 | $12K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 150 | $14K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 149 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.