| 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 | $11K | — | $11K | 10.70% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | RELIANCE STANDARD | $4K | $1K | $5K | 9.88% |
| KYLE ELLISON3 | 1281 E. MARIGOLD DRIVE BLOOMINGTON, IN 47401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 8.61% |
| PETER J EMMERT3 Filed as: PETER EMMERT | 5904 OAKFORGE LANE INDIANAPOLIS, IN 46254 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.97% |
| DANIEL R HARPER JR3 Filed as: DANIEL HARPER | 1028 S. BELVEDER E AVENUE GASTONIA, NC 28054 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.67% |
| BOBBY BURGETT3 | 2601 FORTUNE CIRCLE EAST SUITE 103A INDIANAPOLIS, IN 46241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $855 | — | $855 | 2.54% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | RELIANCE STANDARD | $4K | $700 | $4K | 13.85% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | RELIANCE STANDARD | $3K | $577 | $4K | 15.29% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | VSP | $1K | — | $1K | 4.77% |
| KYLE ELLISON3 | 1281 E MARIGOLD DRIVE BLOOMINGTON, IN 47401 | AFLAC | $1K | — | $1K | 23.35% |
| ROBERT BURGETT3 | 1701 W 18TH STREET SUITE A INDIANAPOLIS, IN 46202 | AFLAC | $201 | — | $201 | 4.54% |
| PETER J EMMERT3 Filed as: PETER EMMERT | 1701 W 18TH STREET INDIANAPOLIS, IN 46202 | AFLAC | $191 | — | $191 | 4.31% |
| BIANCA EUCLIDE3 | 1048 W 17TH STREET BLOOMINGTON, IN 47404 | AFLAC | $147 | — | $147 | 3.32% |
| KIMBERLY BURKE3 | 6462 RATTLESNAKE ROAD SPENCER, IN 47460 | AFLAC | $124 | — | $124 | 2.80% |
| PETER J EMMERT3 Filed as: PETER EMMERT | 1048 W 17TH STREET BLOOMINGTON, IN 47404 | AFLAC | $117 | — | $117 | 2.64% |
| RONALD F REMAK INSURANCE INC3 Filed as: RONALD F. REMAK INSURANCE, INC. | 306 SR 446 BLOOMINGTON, IN 47401 | SIHO | $2K | $66K | $68K | — |
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 | 272 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CORPORATE MANAGEMENT SERVICES | 354 | $10K |
| Dental | DELTA DENTAL | 315 | $103K |
| Vision | VSP | 165 | $25K |
| Life insurance | RELIANCE STANDARD | 213 | $25K |
| Short-term disability(2 contracts) | RELIANCE STANDARD | 213 | $77K |
| Long-term disability | RELIANCE STANDARD | 213 | $31K |
| Prescription drug | SIHO | 354 | $0 |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD | 213 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.