| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE GROUP LLC | 6628 CONSTITUTION DRIVE FORT WAYNE, IN 46804 | AMERICAN UNITED LIFE INSURANCE COMPANY | $44K | — | $44K | 6.77% |
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE GROUP | 6628 CONSTITUTION DRIVE FORT WAYNE, IN 46804 | AFLAC | $13K | — | $13K | 6.62% |
| ERIC BROGAN3 Filed as: ERIC SPENGEL | 1005 WESCOTT DRIVE FORT WAYNE, IN 46818 | AFLAC | $5K | $885 | $6K | 2.79% |
| DONALD E SPRINGER3 | 5715 RIVER RUN TRAIL FORT WAYNE, IN 46825 | AFLAC | $5K | $379 | $5K | 2.41% |
| JONATHAN DAVID BESWARICK3 | 220 INSURANCE DRIVE FORT WAYNE, IN 46825 | AFLAC | $2K | $295 | $2K | 0.90% |
| SARA BRITA3 | 1005 WESCOTT DRIVE FORT WAYNE, IN 46818 | AFLAC | $2K | $44 | $2K | 0.87% |
| BRIAN WHITE3 Filed as: BRIAN GREGORY DILL | 4614 N 615 W HUNTINGTON, IN 46750 | AFLAC | $1K | $117 | $1K | 0.61% |
| ROBERT J LAWRENCE3 Filed as: ROBERT LAWRENCE | 15409 SPENCERVILLE ROAD GRABILL, IN 46741 | AFLAC | $993 | $76 | $1K | 0.53% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN COURT | 11206 SHALIMAR DRIVE FORT WAYNE, IN 46845 | AFLAC | $577 | — | $577 | 0.28% |
| TERRY J SILVERS3 Filed as: TERRY SEILER | 220 INSURANCE DRIVE FORT WAYNE, IN 46825 | AFLAC | $286 | $267 | $553 | 0.27% |
| NICHOLAS DEAN SHIPE3 | 11037 BROADWAY SUITE C CROWN POINT, IN 46307 | AFLAC | $487 | — | $487 | 0.24% |
| MOLLY KURTZ3 Filed as: MOLLY MAIRE KURTZ | 1154 E 900 N OSSIAN, IN 46777 | AFLAC | $374 | — | $374 | 0.18% |
| JUSTIN C CARSON3 Filed as: JUSTIN FINTON | 112 S. ANDERSON STREET ELWOOD, IN 46036 | AFLAC | $373 | — | $373 | 0.18% |
| LESTES NIVENS3 | 1201 LIMBERLOST TRAIL ROME CITY, IN 46784 | AFLAC | $370 | — | $370 | 0.18% |
| TAYLOR ELLIS3 | 220 INSURANCE DRIVE SUITE A FORT WAYNE, IN 46825 | AFLAC | $333 | — | $333 | 0.16% |
| MICHELLE L SEXTON3 Filed as: MICHELLE SEXTON | 220 INSURANCE DRIVE SUITE A FORT WAYNE, IN 46825 | AFLAC | $299 | — | $299 | 0.15% |
| MICHAEL MCEVOY3 | 376 N WALNUT STREET COLUMBIA CITY, IN 46725 | AFLAC | $276 | — | $276 | 0.14% |
| CHARLES D. BLOCK3 Filed as: CHARLES GRAY | 3112 MARIAS DRIVE FORT WAYNE, IN 46815 | AFLAC | $232 | — | $232 | 0.11% |
| JEREMY JAY JOHNSON3 | 7263 BRAXTON DRIVE NOBLESVILLE, IN 46062 | AFLAC | $178 | — | $178 | 0.09% |
| RICHARD UHRICK3 | 11818 E 200 S LAOTTO, IN 46763 | AFLAC | $165 | — | $165 | 0.08% |
| LORI MINYARD3 | 9247 N MERIDIAN STREET 205 INDIANAPOLIS, IN 46260 | AFLAC | $155 | — | $155 | 0.08% |
| DOUGLAS FOX3 | 6836 THAYER LAKE DRIVE ALDEN, MI 49612 | AFLAC | $143 | — | $143 | 0.07% |
| ROBIN M CALLAWAY3 Filed as: ROBIN ASKINS | 427 N. LINCOLN PARK WARSAW, IN 46582 | AFLAC | $140 | — | $140 | 0.07% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB ROAD FLOYDS KNOBS, IN 47119 | AFLAC | $136 | — | $136 | 0.07% |
| DAVID J MCCLELLAN3 Filed as: DAVID KREMER | 2150 ASSOCIATION DRIVE 150 OKEMOS, MI 48864 | AFLAC | $118 | — | $118 | 0.06% |
| JOHN TYLER & ASSOCIATES3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $118 | — | $118 | 0.06% |
| DANNY R. OSTER3 Filed as: DANNY WHITMIRE | 16474 PRETTY VIEW DRIVE PLYMOUTH, IN 46563 | AFLAC | $113 | — | $113 | 0.06% |
| JEFFREY S HINES3 | 6225 SUGAR TREE PLACE FORT WAYNE, IN 46835 | AFLAC | $107 | — | $107 | 0.05% |
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE GROUP LLC | 6628 CONSTITUTION DRIVE FORT WAYNE, IN 46804 | EYE MED | $6K | — | $6K | 8.27% |
| INNOVATIVE BROKER SOLUTIONS LTD3 Filed as: INNOVATIVE BROKER SOLUTIONS | 9405 BORMET DRIVE MOKENA, IL 60448 | EYE MED | $2K | — | $2K | 2.48% |
No Schedule C service providers reported on this filing.
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 | 993 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 997 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYE MED | 1,267 | $76K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 1,119 | $645K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 1,119 | $645K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 1,119 | $847K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,267 | — |
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."
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.