| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | P.O. BOX 610 PLYMOUTH, IN 46563 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | — | $9K | 9.84% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE GROUP | P.O. BOX 610 PLYMOUTH, IN 46563 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 15.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE GROUP | P.O. BOX 610 PLYMOUTH, IN 46563 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 15.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE GROUP | P.O. BOX 610 PLYMOUTH, IN 46563 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | P.O. BOX 11177 SOUTH BEND, IN 46634 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.99% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE GROUP | P.O. BOX 610 PLYMOUTH, IN 46563 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $141 | — | $141 | 14.97% |
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 160 | $89K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 250 | $16K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 267 | $68K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $61K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 82 | $18K |
| Other(2 contracts, 2 carriers) | NEW AVENUES, INC. | 275 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.