| 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 | GREENWICH INSURANCE COMPANY | $64K | — | $64K | 8.11% |
| PRO-CLAIM PLUS INC5 Filed as: PRO-CLAIM PLUS INC. | 1700 MAGNAVOX WAY, STE 201 FORT WAYNE, IN 46804 | GREENWICH INSURANCE COMPANY | $0 | $37K | $37K | 4.70% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM & FLOWER OF IN, INC. | 10441 ILLINOIS ROAD FORT WAYNE, IN 46814 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 10.26% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM & FLOWER OF IN, INC. | 10441 ILLINOIS ROAD FORT WAYNE, IN 46814 | AMERICAN UNITED LIFE INSURANCE COMPANY | $5K | — | $5K | 13.50% |
| DEVORE & CHAPEL, INC.3 Filed as: DEVORE & CHAPEL INC. | 10441 ILLINOIS ROAD FORT WAYNE, IN 46814 | AMERICAN UNITED LIFE INSURANCE COMPANY | $150 | — | $150 | 0.37% |
| MICHELLE L SEXTON3 | 220 INSURANCE DR STE A FORT WAYNE, IN 46825 | AFLAC | $352 | — | $352 | 2.63% |
| JONATHAN DAVID BESWARICK3 | 220 INSURANCE DR FORT WAYNE, IN 46825 | AFLAC | $134 | — | $134 | 1.00% |
| NICHOLAS DEAN SHIPE3 | 11037 BROADWAY STE C CROWN POINT, IN 46307 | AFLAC | $72 | — | $72 | 0.54% |
| SUE E. JOHNSON3 | 3492 E 100 N GREENFIELD, IN 46140 | AFLAC | $60 | — | $60 | 0.45% |
| DONALD E SPRINGER3 | 5715 RIVER RUN TRL FORT WAYNE, IN 46825 | AFLAC | $52 | — | $52 | 0.39% |
| JUSTIN E FINTON3 | 112 S ANDERSON ST ELWOOD, IN 46036 | AFLAC | $42 | — | $42 | 0.31% |
| LINDA JOHNSON3 Filed as: LINDA S JOHNSON | 7263 BRAXTON DR NOBLESVILLE, IN 46062 | AFLAC | $33 | — | $33 | 0.25% |
| KRISTINA A. ESSENBERG3 | 1200 N 290 W ANGOLA, IN 46703 | AFLAC | $32 | — | $32 | 0.24% |
| JEREMY JAY JOHNSON3 Filed as: JEREMY JAX JOHNSON | 7263 BRAXTON DR NOBLESVILLE, IN 46062 | AFLAC | $29 | — | $29 | 0.22% |
| SHERIE L SUMPTER3 | 140 EMS B48 LANE WARSAW, IN 46582 | AFLAC | $25 | — | $25 | 0.19% |
| KYLE L KAUFFMAN3 | PO BOX 1877 WARSAW, IN 46581 | AFLAC | $13 | — | $13 | 0.10% |
| JOHN H. THOMPSON3 Filed as: JOHN H THOMPSON | 5019 MICHIGAN RD PLYMOUTH, IN 46563 | AFLAC | $12 | — | $12 | 0.09% |
| RICHARD YOUNGBERG3 | PO BOX 6100 OCEANSIDE, CA 92058 | AFLAC | $10 | — | $10 | 0.07% |
| MICHAEL E MITMAN3 | 908 N WAYNE ST STE B ANGOLA, IN 46703 | AFLAC | $10 | — | $10 | 0.07% |
| JOHN F GLAUB3 | 54369 30TH ST. SOUTH BEND, IN 46635 | AFLAC | $9 | — | $9 | 0.07% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $6 | — | $6 | 0.04% |
| CHARLES L GRAY3 | 3122 MARIAS DR FORT WAYNE, IN 46815 | AFLAC | $6 | — | $6 | 0.04% |
| MATTHEW A COOK3 | 10069 BENT TREE LN FISHERS, IN 46037 | AFLAC | $3 | — | $3 | 0.02% |
| CARRIE C SCHRAMM3 | 10418 PRETTY LAKE TRL PLYMOUTH, IN 46563 | AFLAC | $3 | — | $3 | 0.02% |
| MARK A WOJDA3 | 16258 DOGWOOD LANE PLYMOUTH, IN 46563 | AFLAC | $1 | — | $1 | 0.01% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $1 | — | $1 | 0.01% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE CT PLAINFIELD, IN 46168 | AFLAC | $1 | — | $1 | 0.01% |
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 | 135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GREENWICH INSURANCE COMPANY | 243 | $810K |
| Dental(2 contracts, 2 carriers) | GREENWICH INSURANCE COMPANY | 243 | $810K |
| Vision(2 contracts, 2 carriers) | GREENWICH INSURANCE COMPANY | 243 | $810K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 147 | $54K |
| Short-term disability(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 83 | $91K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 147 | $40K |
| Prescription drug(2 contracts, 2 carriers) | GREENWICH INSURANCE COMPANY | 243 | $810K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | GREENWICH INSURANCE COMPANY | 243 | $810K |
| Other(3 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 147 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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.