| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH84, LLC3 | 19 CARNABY DRIVE BROWNSBURG, IN 46112 | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | $2K | — | $2K | 0.99% |
| NORTH84, LLC3 | 19 CARNABY DRIVE BROWNSBURG, IN 46112 | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | $13K | — | $13K | 10.00% |
| NORTH84, LLC3 | 19 CARNABY DRIVE BROWNSBURG, IN 46112 | THE LINCOLN FINANCIAL LLIFE INSURANCE COMPANY | $19K | — | $19K | 15.00% |
| NORTH84, LLC3 | 19 CARNABY DRIVE BROWNSBURG, IN 46112 | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| NORTH84, LLC3 | 19 CARNABY DRIVE BROWNSBURG, IN 46112 | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| NORTH84, LLC3 | 19 CARNABY DRIVE BROWNSBURG, IN 46112 | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA INSURANCE COMPANY EIN 39-1263473 TPA | Contract Administrator; Claims processing Service code 12 | PO BOX 4600 CAROL STREAM, IL 60197 | $331K |
| PROSPECTIVE RISK MANAGEMENT EIN 20-4770398 ACTUARY | Actuarial Service code 11 | 4348 SOUTHPOINT BOULEVARD SUITE 410 JACKSONVILLE, FL 32216 | $37K |
| PEO AUXILLIARY EIN 82-5347155 TPA | Contract Administrator Service code 13 | 812 E DAYTON STREET SUITE 150 MADISON, WI 53705 | $17K |
| EVERYTHING BENEFITS EIN 46-5072394 TPA | Contract Administrator Service code 13 | 1253 SPRINGFIELD AVENUE SUITE 350 NEW PROVIDENCE, NJ 07974 | $12K |
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 | 1,788 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,804 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HUMANA INSURANCE COMPANY | 1,081 | $107K |
| Life insurance | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | 582 | $209K |
| Short-term disability(2 contracts) | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | 341 | $166K |
| Long-term disability(2 contracts) | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | 374 | $185K |
| Other(2 contracts, 2 carriers) | THE LINCOLN FINANCIAL LIFE INSURANCE COMPANY | 1,788 | $333K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,788 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.