| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JA BENEFITS LLC | 1630 H STREET BEDFORD, IN 47421 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $30K | $0 | $30K | 13.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 THIRD PARTY ADMINISTRATOR | Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | $68K |
| DUNN & ASSOC BENEFIT ADMINISTRATORS EIN 35-1861364 THIRD PARTY ADMINISTRATOR | Claims processing; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services Service code 12 | 4550 MIDDLE ROAD, SUITE A COLUMBUS, IN 47203 | $17K |
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 NETWORK PHARMACY MARGIN | Other fees Service code 99 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | $12K |
| THE GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | 7 HANOVER SQUARE NEW YORK, NY 10004 | $9K |
| TASC EIN 39-1561025 FSA ADMINISTRATION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $6K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 SUBCONTRACTOR FOR ANTHEM | Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $0 |
| JA BENEFITS, LLC EIN 35-0781558 BROKER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers; Non-monetary compensation Service code 22 | P.O. BOX 159 BEDFORD, IN 47421 | $0 |
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 | 454 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 455 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 431 | $223K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 431 | $223K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 431 | $223K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 431 | $223K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. (G2001) | 244 | $359K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 431 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 431 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.