| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURT ADVISORY GROUP3 | 307 S. MAIN STREET, SUITE 302 ELKHART, IN 46516 | AMERICAN UNITED LIFE INSURANCE COMPANY | — | $12K | $12K | 9.61% |
| NORTH AMERICAN BENEFITS COMPANY5 | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | AMERICAN UNITED LIFE INSURANCE COMPANY | — | $9K | $9K | 7.34% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFITS PROGRAMS, INC. | 897 12TH STREET PO BOX 1116 HAMMONTON, NJ 08037 | RELIASTAR LIFE INSURANCE COMPANY | $23K | $0 | $23K | 23.90% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PL CHICAGO, IL 60673 | RELIASTAR LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.20% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | PO BOX 955909 SAINT LOUIS, MO 63195 | ANTHEM INSURANCE COMPANIES, INC. | $3K | $0 | $3K | 10.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INGENIORX, INC. EIN 82-3062245 INGENIORX, INC. | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing Service code 12 | — | $233K |
| ANTHEM INSURANCE COMPANIES INC. EIN 35-0781558 ASO | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | — | $196K |
| AON RISK SERVICES CENTRAL, INC. BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 123 N WACKER DRIVE, SUITE 1000 CHICAGO, IL 60606 | $12K |
| ANTHEM INSURANCE COMPANY, INC. | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
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. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE, INC. | 528 | $476K |
| Dental | ANTHEM INSURANCE, INC. | 528 | $476K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 455 | $28K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 1,477 | $224K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 1,477 | $128K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE, INC. | 528 | $476K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,477 | — |
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.