| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SOURCEONE GROUP LLC3 Filed as: SOURCEONE INSURANCE | 6628 CONSTITUTION DR FORT WAYNE, IN 46804 | COMPANION LIFE INSURANCE COMPANY | $92K | — | $92K | 23.24% |
| SOURCEONE GROUP LLC3 Filed as: SOURCEONE INSURANCE | 6628 CONSTITUTION DR FORT WAYNE, IN 46804 | AMERICAN UNITED LIFE INSURANCE COMPANY | $29K | — | $29K | 8.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRO-CLAIM PLUS INC EIN 35-1938551 | Claims processing Service code 12 | 5620 COVENTRY LANE FORT WAYNE, IN 46804 | $128K |
| MEDPARTNERS EIN 90-5058531 | Insurance services Service code 23 | LOCKBOX U PO BOX 11588 FORT WAYNE, IN 468591588 | $46K |
| AKESO CARE MANAGEMENT INC EIN 35-1980029 | Insurance services Service code 23 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | $27K |
| OPTUMRX PBM OF ILLINOIS INC F/K/A C EIN 11-2581812 | Claims processing Service code 12 | 9900 BREN RD E MINNETONKA, MN 55343 | $16K |
| ELECT RX AND HEALTH SOLUTIONS LLC EIN 27-0988331 | Claims processing Service code 12 | 32232 CROSSBOW BEVERLY HILLS, MI 48025 | $8K |
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 | 745 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 752 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE COMPANY | 694 | $395K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 745 | $357K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 745 | $357K |
| Prescription drug | COMPANION LIFE INSURANCE COMPANY | 694 | $395K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 745 | $357K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 745 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.