| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 466012020 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TX HWY AUSTIN, TX 78746 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $78 | $78 | 0.29% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 466012020 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TX HWY AUSTIN, TX 78746 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $93 | $93 | 0.41% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IL 466012020 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | 1250 S CAPITAL OF TX HWY AUSTIN, TX 78746 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $72 | $72 | 0.35% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 466012020 | VISION SERVICE PLAN | $815 | $0 | $815 | 5.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Float revenue; Claims processing; Other fees Service code 12 | 2300 MAIN ST. IRVINE, CA 92614 | $297K |
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 | 149 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 295 | $100K |
| Vision | VISION SERVICE PLAN | 100 | $16K |
| Life insurance(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 148 | $48K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 148 | $23K |
| Other(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 149 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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."
No prospect flags tripped on this filing.