| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN HEALTHCARE GROUP, INC.3 Filed as: AMERICAN HEALTHCARE GROUP INC | 2920 E 96TH ST SUITE C INDIANAPOLIS, IN 46240 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $21K | $7K | $29K | 19.61% |
| DWIGHT GOSSETT3 | 13070 ABRAHAM RUN CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $508 | $3 | $511 | 5.46% |
| DAVID PAUL BURNETT3 Filed as: DAVID BURNETT | 10075 NIAGARA DRIVE FISHERS, IN 46037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $396 | — | $396 | 4.23% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $81 | $4 | $85 | 0.91% |
| DENNIS W BYERS3 | 8739 PROMONTORY RD INDIANAPOLIS, IN 46236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.20% |
| LARRY D DENNY3 Filed as: LARRY W DYKES | 1050 E 86TH ST STE 55-C INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $363 | — | $363 | 5.23% |
| DAVID PAUL BURNETT3 | 10075 NIAGARA DR FISHERS, IN 46037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70 | — | $70 | 1.01% |
| PARRISH J PEACHEE3 | 6152 PUNKINVINE RD LEBANON, IN 46052 | AFLAC | $28 | — | $28 | 7.95% |
| RANDAL R YURCZYK3 | 6858 EAST 525 SOUTH WHITESTOWN, IN 46075 | AFLAC | $6 | — | $6 | 1.70% |
| LLOYD W HUGHES3 | 3775 N STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $2 | — | $2 | 0.57% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $2 | — | $2 | 0.57% |
| USI INSURANCE SERVICES LLC3 | 302 E JACKSON ST MUNCIE, IN 47305 | AFLAC | $0 | — | $0 | 0.00% |
| DAVID PAUL BURNETT3 | 10075 NIAGARA DR FISHERS, IN 46037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 1.85% |
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 | 166 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 12 | $9K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $146K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $146K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $146K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 12 | $10K |
| Long-term disability(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $154K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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.
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.