| 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) | $34K | — | $34K | 3.70% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 3430 CARMEL, IN 46082 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $29K | — | $29K | 7.44% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $2K | $23K | 34.79% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $53 | $10K | 31.77% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $336 | $3K | 35.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC EIN 35-0781558 | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | 3350 PEACHTREE ROAD ATLANTA, GA 303261039 | $607K |
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 | 406 | 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) | 406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC (G2001) | 895 | $918K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 406 | $392K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 406 | $392K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 708 | $67K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 505 | $31K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 708 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 895 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.