| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SYCAMORE INS ASSOC LLC3 Filed as: SYCAMORE INSURANCE ASSOCIATION LLC | 4270 CART PATH TERRE HAUTE, IN 47802 | ANTHEM INSURANCE COMPANIES, INC. | $13K | — | $13K | 1.55% |
| SYCAMORE INS ASSOC LLC3 Filed as: SYCAMORE INSURANCE ASSOCIATION LLC | 999 OHIO STREET TERRE HAUTE, IN 47807 | ANTHEM INSURANCE COMPANIES, INC. | $9K | — | $9K | 0.98% |
| STREAMLINE ENTERPRISES LLC3 | DBA CANOPYNATION 3725 CHAMPION HILLS DRIVE STE 3300 MEMPHIS, TN 38125 | ANTHEM INSURANCE COMPANIES, INC. | $2K | — | $2K | 0.25% |
| SYCAMORE INSURANCE ASSOCIATES, LLC3 Filed as: SYCAMORE INSURANCE ASSOCIATES | 999 OHIO STREET TERRE HAUTE, IN 478073737 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $1K | $6K | 8.32% |
| ORMA R SMITH III3 Filed as: ORMA RINEHART SMITH | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 381252597 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.72% |
| LYNN M STEPPE3 | 1208 NORTH FARRIER STREET TERRE HAUTE, IN 47803 | AFLAC | $4K | $28 | $4K | 12.49% |
| WILLIAM RICHARD ELDEN3 | 400 WABASH AVENUE SUITE 10B TERRE HAUTE, IN 47807 | AFLAC | $1K | $6 | $1K | 4.10% |
| SYCAMORE INSURANCE ASSOCIATES, LLC3 Filed as: SYCAMORE INSURANCE ASSOCIATES LLC | 999 OHIO STREET TERRE HAUTE, IN 47807 | AFLAC | $1K | — | $1K | 3.54% |
| ROBERT W BURGETT3 | 1701 WEST 18TH STREET SUITE A INDIANAPOLIS, IN 46202 | AFLAC | $850 | $6 | $856 | 2.42% |
| ONB INSURANCE GROUP INC.3 Filed as: ONB INSURANCE GROUP INC | P.O. BOX 1488 TERRE HAUTE, IN 47808 | AFLAC | $206 | — | $206 | 0.58% |
| LARRY P WYNDHAM3 | 55 SOUTH FOREST AVENUE BRAZIL, IN 47834 | AFLAC | $57 | — | $57 | 0.16% |
| THOMAS H SWAN3 | 4317 GOLF BAG LANE TERRE HAUTE, IN 47802 | AFLAC | $48 | — | $48 | 0.14% |
| FREDRICK EITEL3 | 602 NORTH 8TH STREET MARSHALL, IL 62441 | AFLAC | $43 | — | $43 | 0.12% |
| WARREN REID HAVENOR3 | 306 SOUTH STATE ROAD 446 BLOOMINGTON, IN 47401 | AFLAC | $24 | — | $24 | 0.07% |
| CHRISTOPHER RYAN CORDON3 | 1080 BLACKHAWK DRIVE ELGIN, IL 60120 | AFLAC | $19 | — | $19 | 0.05% |
| PETER J EMMERT3 | 5904 OAKFORGE LANE INDIANAPOLIS, IN 46254 | AFLAC | $18 | — | $18 | 0.05% |
| J THEIS & ASSOCIATES INC3 | 1825 DUVAL DRIVE LAUREL, MT 59044 | AFLAC | $16 | — | $16 | 0.05% |
| ROBERT E JONES3 | 55 SOUTH FOREST AVENUE BRAZIL, IN 47834 | AFLAC | $12 | — | $12 | 0.03% |
| JAMES A BURRESS3 | 8755 OGDEN DUNES DRIVE CAMBY, IN 46113 | AFLAC | $12 | — | $12 | 0.03% |
| SHARYL K BATHE3 | 620 ODD FELLOW ROAD MATTOON, IL 61938 | AFLAC | $11 | — | $11 | 0.03% |
| KEVIN M VERST3 | 4573 IRONWOOD LANE TERRE HAUTE, IN 47802 | AFLAC | $11 | — | $11 | 0.03% |
| FRANCES R WYNDHAM3 | 722 WEST NORTH STREET BRAZIL, IN 47834 | AFLAC | $10 | — | $10 | 0.03% |
| BETTY ANN RICHARDSON3 | 4643 NORTH LAFAYETTE STREET TERRE HAUTE, IN 47805 | AFLAC | $9 | — | $9 | 0.03% |
| KEVIN M VERST3 | 4573 IRONWOOD LANE TERRE HAUTE, IN 47802 | AFLAC | $5 | — | $5 | 0.01% |
| LLOYD W HUGHES3 | 3775 NORTH STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $5 | — | $5 | 0.01% |
| HARROLD/HUGHES INSURANCE3 Filed as: HARROLD HUGHES INSURANCE | 3775 NORTH STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $5 | — | $5 | 0.01% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $5 | — | $5 | 0.01% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB ROAD FLOYDS KNOBS, IN 47119 | AFLAC | $4 | — | $4 | 0.01% |
| JAMES M FLETCHER3 | 254 JOHN STREET AURORA, IN 47001 | AFLAC | $3 | — | $3 | 0.01% |
| MARK A WOJDA3 | 631 GREENFORD TRAIL WEST CARMEL, IN 46032 | AFLAC | $3 | — | $3 | 0.01% |
| MATTHEW A COOK3 | 10069 BENT TREE LANE FISHERS, IN 46037 | AFLAC | $3 | — | $3 | 0.01% |
| JOHN TYLER & ASSOCIATES3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $2 | — | $2 | 0.01% |
| PETER J EMMERT3 | 1701 WEST 18TH STREET SUITE A INDIANAPOLIS, IN 46202 | AFLAC | $2 | — | $2 | 0.01% |
| JOHN T CLANCY3 | 4025 PETE DYE BOULEVARD CARMEL, IN 46033 | AFLAC | $2 | — | $2 | 0.01% |
| JASON HOFFARD3 | 3415 OFFICE PARK DRIVE SUITE C MARION, IL 62959 | AFLAC | $1 | — | $1 | 0.00% |
| MARTHA MONCKTON3 | 2411 EAST GRANDVIEW AVENUE PEORIA, IL 61614 | AFLAC | $1 | — | $1 | 0.00% |
| AMY N GEHLHAUSEN3 | 3115 HOWARD DRIVE JASPER, IN 47546 | AFLAC | $1 | — | $1 | 0.00% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $1 | — | $1 | 0.00% |
| JENNIFER L MITCHEN3 | 9247 NORTH MERIDIAN STREET SUITE 205 INDIANAPOLIS, IN 46260 | AFLAC | $1 | — | $1 | 0.00% |
| KEVIN F WARD3 | 12632 DOUBLE EAGLE DRIVE CARMEL, IN 46033 | AFLAC | $1 | — | $1 | 0.00% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 115 | $867K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $70K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $70K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $70K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.