| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BOULEVARD SUITE 20 CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $321 | $7K | 11.88% |
| KYLE ELLISON3 Filed as: KYLE R ELLISON | 3524 ELMRIDGE DRIVE EVANSVILLE, IN 47711 | AFLAC | $1K | $4 | $1K | 4.72% |
| PATRICIA ANN JONES3 | 917 ALDEN DRIVE FORTVILLE, IN 46040 | AFLAC | $493 | $15 | $508 | 1.89% |
| ROBERT W BURGETT3 | 1701 WEST 18TH STREET SUITE A INDIANAPOLIS, IN 46202 | AFLAC | $365 | $4 | $369 | 1.37% |
| RITA J ABRAM3 | 11500 GOLDEN WILLOW COURT ZIONSVILLE, IN 46077 | AFLAC | $143 | $4 | $147 | 0.55% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INS LLC | 111 CONGRESSIONAL BOULEVARD SUITE 200 CARMEL, IN 46032 | AFLAC | $145 | — | $145 | 0.54% |
| PETER J EMMERT3 | 5904 OAKFORGE LANE INDIANAPOLIS, IN 46254 | AFLAC | $71 | — | $71 | 0.26% |
| CANDACE Y HILDEBRAN3 | 864 HEATHERWOOD DRIVE GREENWOOD, IN 46143 | AFLAC | $52 | — | $52 | 0.19% |
| MICHAEL DUANE ARNOLD3 | 2147 BUTTONBUSH DRIVE PLAINFIELD, IN 46168 | AFLAC | $28 | — | $28 | 0.10% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $20 | — | $20 | 0.07% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB ROAD FLOYDS KNOBS, IN 47119 | AFLAC | $19 | — | $19 | 0.07% |
| DANIEL R HARPER JR3 | 101 WINDSONG COURT GASTONIA, NC 28056 | AFLAC | $8 | — | $8 | 0.03% |
| JENNIFER L MITCHEN3 | 9247 NORTH MERIDIAN STREET SUITE 205 INDIANAPOLIS, IN 46260 | AFLAC | $7 | — | $7 | 0.03% |
| JOHN T CLANCY3 | 4025 PETE DYE BOULEVARD CARMEL, IN 46033 | AFLAC | $7 | — | $7 | 0.03% |
| MARK A WOJDA3 | 16258 DOGWOOD LANE PLYMOUTH, IN 46563 | AFLAC | $7 | — | $7 | 0.03% |
| MATTHEW A COOK3 | 10069 BENT TREE LANE FISHERS, IN 46037 | AFLAC | $7 | — | $7 | 0.03% |
| DAVID LEVERENZ3 | 2146 SOUTH OAKDALE DRIVE BLOOMINGTON, IN 47403 | AFLAC | $5 | — | $5 | 0.02% |
| HYLANT GROUP INC3 | PO BOX 40925 INDIANAPOLIS, IN 46240 | AFLAC | $3 | — | $3 | 0.01% |
| JA BENEFITS LLC3 Filed as: JA BENEFITS, LLC | PO BOX 159 BEDFORD, IN 47421 | VISION SERVICE PLAN | $747 | — | $747 | 7.02% |
| D'ANN DABELL3 Filed as: D ANN DABELL | 1174 NORTH 2000 EAST LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $65 | — | $65 | 6.66% |
| JULIA VON BARGEN3 | 5 GREEN PLACE CARMEL, IN 46033 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $26 | — | $26 | 2.66% |
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | ANTHEM INSURANCE COMPANIES, INC. | $3K | — | $3K | — |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 0 | $0 |
| Dental | DELTA DENTAL OF INDIANA | 164 | $62K |
| Vision | VISION SERVICE PLAN | 97 | $11K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $57K |
| Short-term disability | AFLAC | 26 | $27K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $57K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 95 | $380K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.