| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 100 CARMEL, IN 46032 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 9.34% |
| INDIANA PROFIT SOLUTIONS INC3 | 4030 LUCKY LN GREENWOOD, IN 46142 | AFLAC | $3K | $504 | $4K | 9.86% |
| KYLE ELLISON3 Filed as: KYLE R ELLISON | 1281 E MARIGOLD DR BLOOMINGTON, IN 47401 | AFLAC | $1K | $233 | $2K | 3.96% |
| ROBERT W BURGETT3 | 2601 FORTUNE CIRCLE EAST SUITE 103A INDIANAPOLIS, IN 46241 | AFLAC | $786 | $268 | $1K | 2.61% |
| NAVILLE & ASSOCIATES3 | 14220 OVERBROOK DR CARMEL, IN 46074 | AFLAC | $222 | $260 | $482 | 1.19% |
| MICHAEL DUANE ARNOLD3 | 2601 FORTUNE CIRCLE E STE 103A INDIANAPOLIS, IN 46241 | AFLAC | $330 | $8 | $338 | 0.84% |
| DANIEL R HARPER JR | 1028 S BELVEDERE AVE GASTONIA, NC 28054 | AFLAC | $91 | $6 | $97 | 0.24% |
| NANCY A SHEVLOT3 Filed as: NANCY A SHELVOT | 310 E 17TH STREET INDIANAPOLIS, IN 46202 | AFLAC | $69 | $13 | $82 | 0.20% |
| RYAN E FRAZIER3 | 220 STONEGATE LN APT B INDIANAPOLIS, IN 46227 | AFLAC | $34 | $24 | $58 | 0.14% |
| BRIANNA LYNN ROWE3 | 410 DUNN ST PLAINFIELD, IN 46168 | AFLAC | $44 | $0 | $44 | 0.11% |
| RITA J ABRAM3 | 2601 FORTUNE CIRCLE EAST SUITE 103 A INDIANAPOLIS, IN 46241 | AFLAC | $28 | $3 | $31 | 0.08% |
| PETER J EMMERT3 | 2601 FORTUNE CIR E STE 103A INDIANAPOLIS, IN 46241 | AFLAC | $29 | $0 | $29 | 0.07% |
| SHERRY S HSU3 | 803 OYSTER CREEK DR SUGAR LAND, TX 77478 | AFLAC | $28 | $0 | $28 | 0.07% |
| TIMOTHY B ASBY3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $21 | $5 | $26 | 0.06% |
| THOMAS ALEX SHEVLOT3 | 7326 ELM RIDGE DR INDIANAPOLIS, IN 46236 | AFLAC | $21 | $0 | $21 | 0.05% |
| DENTON J GILES3 | 9235 LAKEWAY VIEW LN HUMBLE, TX 77396 | AFLAC | $15 | $0 | $15 | 0.04% |
| JOHN P WHELAN3 | 15129 GOODTIME COURT CARMEL, IN 46032 | AFLAC | $5 | $0 | $5 | 0.01% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 100 CARMEL, IN 46032 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 7.49% |
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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ADVANTAGE HEALTH SOLUTIONS, INC. | 173 | $850K |
| Dental | DELTA DENTAL OF INDIANA | 146 | $61K |
| Vision | VISION SERVICE PLAN | 87 | $9K |
| Life insurance | STANDARD INSURANCE COMPANY | 148 | $29K |
| Short-term disability | AFLAC | 53 | $40K |
| Long-term disability | STANDARD INSURANCE COMPANY | 148 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
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.