| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE ST., SUITE 3400 CHICAGO, IL 60661 | ANTHEM INSURANCE COMPANIES, INC. | $129K | — | $129K | 7.95% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE ST., SUITE 3400 CHICAGO, IL 60661 | HARTFORD LIFE AND ACCIDENT | $72K | — | $72K | 10.00% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE ST., SUITE 3400 CHICAGO, IL 60661 | DELTA DENTAL OF INDIANA | $4K | — | $4K | 0.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 ADMINISTRATOR | Claims processing; Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Float revenue Service code 12 | — | $829K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 ADMINISTRATOR | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $205K |
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 | 989 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,002 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 1,711 | $599K |
| Vision | VISION SERVICE PLAN | 508 | $101K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,003 | $724K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,003 | $724K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,003 | $724K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 1,176 | $1.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 1,003 | $724K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,711 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.