| 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 | $38K | — | $38K | 7.44% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $3K | $24K | 17.05% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE STREET FLOOR 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.50% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $2K | $15K | 16.85% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE STREET FLOOR 3 CHICAGO, IL 40654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.50% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 12.69% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 10.90% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 3430 CARMEL, IN 46082 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $209 | $3K | 16.11% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE STREET FLOOR 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $281 | $281 | 1.50% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | 3750 PRIORITY WAY S DRIVE INDIANAPOLIS, IN 46240 | ANTHEM INSURANCE COMPANIES, INC (G2001) | $45K | — | $45K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES INC EIN 35-0781558 | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | 740 W. PEACHTREE STREET NW ATLANTA, GA 30308 | $673K |
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 | 519 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 519 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC (G2001) | 1,097 | $0 |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 519 | $510K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 519 | $510K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 658 | $142K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 658 | $88K |
| Other(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 389 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,097 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.