| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 46601 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $221 | — | $221 | 0.05% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 46601 | PARAMOUNT DENTAL | $4K | — | $4K | 10.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 46601 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $1K | — | $1K | 9.88% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | 202 S MICHIGAN ST STE 1400 SOUTH BEND, IN 46601 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $779 | $64 | $843 | 22.10% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC | 1250 CAPITAL OF TEXAS HWY BLDG 2, STE125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $43 | $43 | 1.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 INSURANCE PROVIDER | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $117K |
| GIBSON INSURANCE AGENCY INC INSURANCE PROVIDER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 333 E JEFFERSON ST PLYMOUTH, IN 46563 | $0 |
| INGENIORX, INC. EIN 82-3062245 INSURANCE PROVIDER | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | -$26K |
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 | 225 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PARAMOUNT DENTAL | 121 | $38K |
| Vision | ANTHEM LIFE INSURANCE COMPANY (G1400) | 142 | $460K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY (G1400) | 224 | $17K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 10 | $4K |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY (G1400) | 142 | $460K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.