| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH AMERICA ADMINISTRATORS, LP5 Filed as: NORTH AMERICA ADMINISTRATORS L.P. | 1826 ELM HILL PIKE NASHVILLE, TN 37210 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 0.75% |
| DIMENSION BENEFITS LLC3 | 4955 KERRINGTON BLVD BARGERSVILLE, IN 461068310 | TRANSAMERICA LIFE INSURANCE COMPANY | $236 | — | $236 | 1.19% |
| MICHAEL J REYNOLDS3 | 4826 PRINCETON WAY NE SEATTLE, WA 981157728 | TRANSAMERICA LIFE INSURANCE COMPANY | $205 | — | $205 | 1.03% |
| JEFFREY L WHISLER3 | 126 1/2 S. MAIN STREET ELKHART, IN 465163122 | TRANSAMERICA LIFE INSURANCE COMPANY | $114 | — | $114 | 0.57% |
| THE HEALY GROUP INC.3 | 53800 GENERATION DRIVE SOUTH BEND, IN 46635 | TRANSAMERICA LIFE INSURANCE COMPANY | $101 | — | $101 | 0.51% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC. | 300 NIBCO PKWY STE 100 ELKHART, IN 465163122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 7.09% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC. | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $562 | $97 | $659 | 4.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTH AMERICAN ADMINISTRATORS EIN 65-0851406 TPA | Contract Administrator Service code 13 | P.O. BOX 1984 NASHVILLE, TN 37202 | $388K |
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 | 498 | 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) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 210 | $34K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 498 | $35K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 177 | $300K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 498 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 498 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.