| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | — | $35K | 7.44% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $1K | $23K | 14.79% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE STREET FLOOR 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.39% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $693 | $13K | 14.51% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE STREET FLOOR 3 CHICAGO, IL 40654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.37% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 9.89% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $172 | $3K | 14.77% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE STREET FLOOR 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $261 | $261 | 1.39% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.65% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | 3750 PRIORITY WAY S DRIVE INDIANAPOLIS, IN 46240 | ANTHEM INSURANCE COMPANIES, INC (G2001) | $42K | $605 | $43K | 20753.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES INC EIN 35-0781558 | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | 740 W. PEACHTREE STREET NW ATLANTA, GA 30308 | $711K |
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 | 479 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC (G2001) | 987 | $205 |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 479 | $474K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 479 | $474K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 974 | $157K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 579 | $87K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 395 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 987 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.