| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3750 PRIORITY WAY S DRIVE INDIANAPOLIS, IN 46240 | ANTHEM INSURANCE COMPANIES, INC (G2001) | $40K | — | $40K | 6.54% |
| HYLANT GROUP INC3 | 6714 POINTE INVERNESS WAY STE 100 FT WAYNE, IN 46804 | ANTHEM INSURANCE COMPANIES, INC (G2001) | $34K | — | $34K | 5.59% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 3430 CARMEL, IN 46082 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 5.64% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 811 MADISON AVE TOLEDO, OH 43604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 1.89% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 12.26% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.74% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 12.39% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 811 MADISON AVE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 2.61% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.25% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $324 | — | $324 | 1.75% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 12.31% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $365 | — | $365 | 2.69% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $994 | — | $994 | 8.26% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $210 | — | $210 | 1.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC EIN 35-0781558 | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 3350 PEACHTREE ROAD ATLANTA, GA 303261039 | $471K |
| MJ INSURANCE INC | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 3750 PRIORITY WAY S DR INDIANAPOLIS, IN 46240 | $40K |
| HYLANT GROUP INC EIN 34-1880366 | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | PO BOX 40925 INDIANAPOLIS, IN 46280 | $34K |
| INGENIO RX, INC. | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | — | -$21K |
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 | 441 | 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) | 441 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC (G2001) | 801 | $611K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 608 | $307K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 608 | $307K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 636 | $101K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 441 | $45K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 636 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 801 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.