| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEVORE & CHAPEL, INC.3 Filed as: DEVORE & CHAPEL INC. | 10441 ILLINOIS ROAD FORT WAYNE, IN 46814 | COMPANION LIFE INSURANCE CO. | $44K | — | $44K | 11.11% |
| PRO-CLAIM PLUS INC5 Filed as: PRO-CLAIM PLUS INC. | 5620 COVENTRY LANE FORT WAYNE, IN 46804 | COMPANION LIFE INSURANCE CO. | — | $29K | $29K | 7.35% |
| UNIFIED EMPLOYEE BENEFITS3 | 2900 S 70TH ST, SUITE 300 LINCOLN, NE 68506 | TRANSAMERICA LIFE INSURANCE CO. | $60K | — | $60K | 63.20% |
| SUE E. JOHNSON3 | PO BOX 155 WOLFLAKE, IN 46796 | AFLAC | $294 | — | $294 | 2.00% |
| NORMAN E. JOHNSON, TO THE ESTATE OF3 | 1984 S SUGAR GUM TRAIL GREENFIELD, IN 46140 | AFLAC | $259 | — | $259 | 1.76% |
| JOEL GOSS3 | 170 W 060 S LAGRANGE, IN 46761 | AFLAC | $123 | — | $123 | 0.84% |
| NICHOLAS E VIGIL3 Filed as: NICHOLAS SHIPE | 139 W LAKE LANSING RD STE 200 EAST LANSING, IN 46823 | AFLAC | $88 | — | $88 | 0.60% |
| KRISTINA A. ESSENBERG3 | 1200 N 290 W ANGOLA, IN 46703 | AFLAC | $80 | — | $80 | 0.54% |
| JUSTIN E FINTON3 | 220 INSURANCE DR., SUITE A FORT WAYNE, IN 46825 | AFLAC | $50 | — | $50 | 0.34% |
| SHERRIE SUMPTER3 Filed as: SHERRIE BAUGHER | 41 EMS T6A LANE LEESBURG, IN 46538 | AFLAC | $49 | — | $49 | 0.33% |
| DONALD E SPRINGER3 | 200 INSURANCE DR., STE A FORT WAYNE, IN 46825 | AFLAC | $48 | — | $48 | 0.33% |
| JEREMY JAY JOHNSON3 Filed as: JEREMY JOHNSON | 7263 BRAXTON DR. NOBLESVILLE, IN 46062 | AFLAC | $46 | — | $46 | 0.31% |
| CHARLES D. BLOCK3 Filed as: CHARLES GRAY | 105 DAVENTRY LANE, STE 100 LOUISVILLE, KY 40223 | AFLAC | $44 | — | $44 | 0.30% |
| LESTES NIVENS3 | 1201 LIMBERLOST TRL ROME CITY, IN 46784 | AFLAC | $41 | — | $41 | 0.28% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN COURT | 11206 SHALIMAR DR FORT WAYNE, IN 46845 | AFLAC | $38 | — | $38 | 0.26% |
| LINDA JOHNSON3 | 7263 BRAXTON DR NOBLESVILLE, IN 46062 | AFLAC | $36 | — | $36 | 0.25% |
| MICHAEL E MITMAN3 Filed as: MICHAEL E. MITMAN | 308 S SUPERIOR ST ANGOLA, IN 46703 | AFLAC | $34 | — | $34 | 0.23% |
| KYLE L KAUFFMAN3 | PO BOX 1877 WARSAW, IN 46581 | AFLAC | $28 | — | $28 | 0.19% |
| SHIRLEY HILE3 | 5635 W 100 S KIMMELL, IN 46760 | AFLAC | $27 | — | $27 | 0.18% |
| HARROLD/HUGHES INSURANCE3 | 3775 N US 52 LEBANON, IN 46052 | AFLAC | $22 | — | $22 | 0.15% |
| JOHN THOMPSON3 | 4602 NEWAYGO RD FORT WAYNE, IN 46808 | AFLAC | $21 | — | $21 | 0.14% |
| DOUGLAS FOX3 | 735 S GARFIELD AVE STE 203 TRAVERSE CITY, MI 49686 | AFLAC | $20 | — | $20 | 0.14% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN GLAUB | 54369 30TH ST. SOUTH BEND, IN 46635 | AFLAC | $15 | — | $15 | 0.10% |
| NAVILLE & ASSOCIATES3 | 14220 OVERBROOK DR CARMEL, IN 46074 | AFLAC | $14 | — | $14 | 0.10% |
| BERN MCGRANE3 | 24593 BELMAR DR ELKHART, IN 46517 | AFLAC | $10 | — | $10 | 0.07% |
| IMELDA YOUNGBERG3 | 5176 BELLA COLLIMA ST OCEANSIDE, CA 92056 | AFLAC | $10 | — | $10 | 0.07% |
| MARSHA HUGHES3 | 3775 N STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $4 | — | $4 | 0.03% |
| BRADLEY K HARRISON3 | 3432 W TRUMAN BLVD JEFFERSON CITY, MO 65109 | AFLAC | $3 | — | $3 | 0.02% |
| JOHN TYLER & ASSOCIATES3 | 130 DUCK HAWK WAY MARIETTA, SC 29661 | AFLAC | $3 | — | $3 | 0.02% |
| DEVORE & CHAPEL, INC.3 Filed as: DEVORE & CHAPEL INC. | 10441 ILLINOIS ROAD FORT WAYNE, IN 46814 | AMERICAN UNITED LIFE INSURANCE COMPANY | $1K | — | $1K | 13.00% |
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 | 131 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE CO. | 278 | $495K |
| Dental | COMPANION LIFE INSURANCE CO. | 248 | $400K |
| Vision | COMPANION LIFE INSURANCE CO. | 248 | $400K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE CO. | 278 | $103K |
| Long-term disability | TRANSAMERICA LIFE INSURANCE CO. | 278 | $95K |
| Prescription drug | COMPANION LIFE INSURANCE CO. | 248 | $400K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE CO. | 248 | $400K |
| Other(3 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE CO. | 278 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.