| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PLATINUM BENEFIT CONSULTING GROUP3 | 4215 EDISON LAKES PARKWAY STE 200 MISHAWAKA, IN 46545 | ANTHEM INSURANCE COMPANIES, INC. | $13K | — | $13K | 1.86% |
| INDIANA CHAMBER INSURANCE AGENCY3 | 115 WEST WASHINGTON ST SUITE 850S INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES, INC. | $328 | — | $328 | 0.05% |
| PLATINUM BENEFIT CONSULTING GROUP3 | 4215 EDISON LAKES PARKWAY STE 200 MISHAWAKA, IN 46545 | ANTHEM INSURANCE COMPANIES, INC. | $4K | — | $4K | 1.92% |
| INDIANA CHAMBER INSURANCE AGENCY3 | 115 WEST WASHINGTON ST STE 850S INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES, INC. | $88 | — | $88 | 0.05% |
| PLATINUM BENEFIT CONSULTING GROUP3 | 4215 EDISON LAKES PKWY STE 200 MISHAWAKA, IN 46545 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $7K | $18K | 15.91% |
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 | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | ANTHEM INSURANCE COMPANIES, INC. | 105 | $906K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $111K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $111K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $111K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $111K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.