| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | ANTHEM INSURANCE COMPANIES INC | $41K | — | $41K | 4.22% |
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | DELTA DENTAL OF INDIANA | $0 | — | $0 | 0.00% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 100 CARMEL, IN 46032 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 8.36% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND CO INC | EMPIRE STATE BUILDING 350 5TH AVE STE 3700 NEW YORK, NY 10118 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 2.89% |
| NFP INSURANCE SERVICES INC3 | BLDG 2 STE 125 1250 CAPITAL OF TX HWY AUSTIN, TX 78746 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.28% |
| KYLE ELLISON3 Filed as: KYLE R ELLISON | 1281 E MARIGOLD DR BLOOMINGTON, IN 47401 | AFLAC | $2K | $102 | $3K | 7.32% |
| ROBERT W BURGETT3 | 1701 W 18TH ST STE A INDIANAPOLIS, IN 46202 | AFLAC | $645 | $30 | $675 | 1.94% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INS LLC | 1200 W CARMEL DR CARMEL, IN 46032 | AFLAC | $214 | $0 | $214 | 0.61% |
| PETER J EMMERT3 | 5904 OAKFORGE LN INDIANAPOLIS, IN 46254 | AFLAC | $166 | $0 | $166 | 0.48% |
| BRIANNA LYNN ROWE | 3386 CHALICE CT PLAINFIELD, IN 46168 | AFLAC | $52 | $0 | $52 | 0.15% |
| MICHAEL DUANE ARNOLD3 | 2147 BUTTONBUSH DR PLAINFIELD, IN 46168 | AFLAC | $49 | $0 | $49 | 0.14% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB RD FLOYDS KNOBS RD, IN 47119 | AFLAC | $42 | $0 | $42 | 0.12% |
| PERENNIAL INS AGENCY COMPANY3 | 803 OYSTER CREEK DR SUGAR LAND, TX 77478 | AFLAC | $33 | $0 | $33 | 0.09% |
| DENTON J GILES3 | 4526 BROOK SHADOW DR KINGWOOD, TX 77345 | AFLAC | $18 | $0 | $18 | 0.05% |
| MATTHEW A COOK3 | 10069 BENT TREE LN FISHERS, IN 46037 | AFLAC | $16 | $0 | $16 | 0.05% |
| MARK A WOJDA3 | 16258 DOGWOOD LN PLYMOUTH, IN 46563 | AFLAC | $15 | $0 | $15 | 0.04% |
| DANIEL R HARPER JR3 | 101 WINDSONG CT GASTONIA, NC 28056 | AFLAC | $14 | $0 | $14 | 0.04% |
| JENNIFER L MITCHEN3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $14 | $0 | $14 | 0.04% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $14 | $0 | $14 | 0.04% |
| RYAN E FRAZIER3 | 220 STONEGATE LN APT B INDIANAPOLIS, IN 46227 | AFLAC | $11 | $0 | $11 | 0.03% |
| JOHN P WHELAN3 | 15129 GOODTIME CT CARMEL, IN 46032 | AFLAC | $6 | $0 | $6 | 0.02% |
| DAVID LEVERENZ3 | 2146 S OAKDALE DR BLOOMINGTON, IN 47403 | AFLAC | $5 | $0 | $5 | 0.01% |
| HYLANT GROUP INC3 | PO BOX 40925 INDIANAPOLIS, IN 46240 | AFLAC | $3 | $0 | $3 | 0.01% |
| KEVIN F WARD3 | 12632 DOUBLE EAGLE DR CARMEL, IN 46033 | AFLAC | $2 | $0 | $2 | 0.01% |
| AMY N GEHLHAUSEN3 | 3115 HOWARD DR JASPER, IN 47546 | AFLAC | $1 | $0 | $1 | 0.00% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 100 CARMEL, IN 46032 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 6.96% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND CO INC | EMPIRE STATE BUILDING 350 5TH AVE STE 3700 NEW YORK, NY 10118 | STANDARD INSURANCE COMPANY | $990 | $0 | $990 | 2.93% |
| NFP INSURANCE SERVICES INC3 | BLDG 2 STE 125 1250 CAPITAL OF TX HWY AUSTIN, TX 78746 | STANDARD INSURANCE COMPANY | $757 | $0 | $757 | 2.24% |
| JA BENEFITS LLC3 | PO BOX 159 BEDFORD, IN 47421 | VISION SERVICE PLAN | $769 | — | $769 | 7.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TOTAL ADMINISTRATIVE SERVICES CORP EIN 39-1561025 NONE | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $5K |
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 | 147 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES INC | 148 | $972K |
| Dental | DELTA DENTAL OF INDIANA | 160 | $63K |
| Vision | VISION SERVICE PLAN | 90 | $11K |
| Life insurance | STANDARD INSURANCE COMPANY | 150 | $34K |
| Short-term disability | AFLAC | 39 | $35K |
| Long-term disability | STANDARD INSURANCE COMPANY | 150 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.