| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH M GOSSMAN JR3 Filed as: JOSEPH GOSSMAN | 10600 BAYPORT ROAD LOUISVILLE, KY 40299 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $460 | — | $460 | 6.01% |
| NORTH SIDE AGENCY GROUP INC.3 | 419 DIAMOND AVENUE EVANSVILLE, IN 47711 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $136 | — | $136 | 1.78% |
| PROFESSIONAL INSURANCE ENROLLERS3 | 10418 PRETTY LAKE TRAIL PLYMOUTH, IN 46563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $65 | — | $65 | 0.85% |
| MARK FRANKLIN SCHWITZ3 | 15031 DURHAM WAY EAST GRANGER, IN 46530 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27 | — | $27 | 0.35% |
| JOSEPH M GOSSMAN JR3 Filed as: JOSEPH GOSSMAN | 10600 BAYPORT ROAD LOUISVILLE, KY 40299 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $541 | — | $541 | 10.68% |
| NORTH SIDE AGENCY GROUP INC.3 | 419 DIAMOND AVENUE EVANSVILLE, IN 47711 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $185 | — | $185 | 3.65% |
| PROFESSIONAL INSURANCE ENROLLERS3 | 10418 PRETTY LAKE TRAIL PLYMOUTH, IN 46563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $51 | — | $51 | 1.01% |
| MARK FRANKLIN SCHWITZ3 | 15031 DURHAM WAY EAST GRANGER, IN 46530 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | — | $37 | 0.73% |
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 | 79 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 111 | $593K |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 46 | $28K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 111 | $593K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 79 | $35K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 79 | $35K |
| Other(4 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 79 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.