| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | PO BOX 159 BEDFORD, IN 47421 | DELTA DENTAL OF INDIANA | $1K | — | $1K | 2.04% |
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | PO BOX 159 BEDFORD, IN 47421 | DELTA DENTAL OF INDIANA | $234 | — | $234 | 0.43% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BOULEVARD SUITE 20 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 19.91% |
| SHEPERD INSURANCE LLC3 | 111 CONGRESSIONAL BLVD, SUITE 20 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 19.91% |
| KYLE ELLISON3 Filed as: KYLE R ELLISON | 3524 ELMRIDGE DRIVE EVANSVILLE, IN 47711 | AFLAC | $637 | — | $637 | 3.98% |
| ROBERT W BURGETT3 | 3670 WEST 141ST STREET CARMEL, IN 46074 | AFLAC | $189 | — | $189 | 1.18% |
| JOSEPH RAY DONOVAN3 | 222 SOUTH MILL STREET PLAINFIELD, IN 46168 | AFLAC | $105 | — | $105 | 0.66% |
| PATRICIA ANN JONES3 | 917 ALDEN DRIVE FORTVILLE, IN 46040 | AFLAC | $84 | — | $84 | 0.52% |
| PETER J EMMERT3 | 5904 OAKFORGE LANE INDIANAPOLIS, IN 46254 | AFLAC | $54 | — | $54 | 0.34% |
| RITA J ABRAM3 | 11500 GOLDEN WILLOW COURT ZIONSVILLE, IN 46077 | AFLAC | $50 | — | $50 | 0.31% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INS LLC | 111 CONGRESSIONAL BOULEVARD SUITE 200 CARMEL, IN 46032 | AFLAC | $49 | — | $49 | 0.31% |
| CANDACE Y HILDEBRAN3 | 1084 KNOLL COURT GREENWOOD, IN 46143 | AFLAC | $39 | — | $39 | 0.24% |
| DEMETRIA A HOLT3 | 10153 MEADOW PATH LANE INDIANAPOLIS, IN 46259 | AFLAC | $21 | — | $21 | 0.13% |
| MICHAEL DUANE ARNOLD3 | 2147 BUTTONBUSH DRIVE PLAINFIELD, IN 46168 | AFLAC | $17 | — | $17 | 0.11% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB ROAD FLOYDS KNOBS, IA 47119 | AFLAC | $14 | — | $14 | 0.09% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $12 | — | $12 | 0.07% |
| DANIEL R HARPER JR3 | 101 WINDSONG COURT GASTONIA, NC 28056 | AFLAC | $8 | — | $8 | 0.05% |
| JENNIFER L MITCHEN3 | 9247 NORTH MERIDIAN STREET SUITE 205 INDIANAPOLIS, IN 46260 | AFLAC | $6 | — | $6 | 0.04% |
| JOHN T CLANCY3 | 4025 PETE DYE BOULEVARD CARMEL, IN 46033 | AFLAC | $6 | — | $6 | 0.04% |
| MARK A WOJDA3 | 16258 DOGWOOD LANE PLYMOUTH, IN 46563 | AFLAC | $6 | — | $6 | 0.04% |
| MATTHEW A COOK3 | 10069 BENT TREE LANE FISHERS, IN 46037 | AFLAC | $6 | — | $6 | 0.04% |
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | PO BOX 159 BEDFORD, IN 47421 | VISION SERVICE PLAN | $689 | — | $689 | 8.01% |
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | 1630 H STREET BEDFORD, IN 47421 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $177 | — | $177 | 10.02% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS GROUP, LLC | 325 NORTH KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $88 | $88 | 4.98% |
| D'ANN DABELL4 Filed as: D ANN DABELL | 3259 EAST 5225 NORTH EADEN, UT 84310 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $154 | — | $154 | 11.69% |
| JULIA VON BARGEN4 | 5 GREEN PLACE CARMEL, IN 46033 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $119 | — | $119 | 9.04% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 130 | $54K |
| Vision | VISION SERVICE PLAN | 81 | $9K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $69K |
| Short-term disability | AFLAC | 12 | $16K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $71K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 78 | $359K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.