| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | DELTA DENTAL OF INDIANA | $9K | — | $9K | 9.97% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | RELIANCE STANDARD | $3K | $0 | $3K | 7.92% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | RELIANCE STANDARD | $3K | $0 | $3K | 12.48% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | RELIANCE STANDARD | $3K | $0 | $3K | 13.43% |
| KYLE ELLISON3 | 1281 E. MARIGOLD DRIVE BLOOMINGTON, IN 47401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 6.05% |
| DANIEL R HARPER JR3 | 1028 S BELVEDER E AVE GASTONIA, NC 28054 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 5.96% |
| PETER J EMMERT3 Filed as: PETER EMMERT | 2601 FORTUNE CIRCLE DRIVE EAST SUITE 103A INDIANAPOLIS, IN 46241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $815 | — | $815 | 3.92% |
| ROBERT W BURGETT3 Filed as: ROBERT W. BURGETT | 2601 FORTUNE CIRCLE EAST SUITE 103A INDIANAPOLIS, IN 46241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $519 | — | $519 | 2.49% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | SOUTHERN INDIANA HEALTH ORGANIZATION | $2K | $58K | $60K | — |
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 | 282 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CORPORATE MANAGEMENT | 316 | $21K |
| Dental | DELTA DENTAL OF INDIANA | 271 | $93K |
| Life insurance | RELIANCE STANDARD | 211 | $22K |
| Short-term disability(2 contracts) | RELIANCE STANDARD | 211 | $68K |
| Long-term disability | RELIANCE STANDARD | 211 | $27K |
| Prescription drug | SOUTHERN INDIANA HEALTH ORGANIZATION | 316 | $0 |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD | 211 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.