| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | ANTHEM INSURANCE COMPANIES INC | $16K | $1K | $17K | 2.51% |
| HENRIOTT GROUP INC3 | 250 MAIN STREET, SUITE 650 LAFAYETTE, IN 47901 | ANTHEM INSURANCE COMPANIES INC | $3K | — | $3K | 0.44% |
| INDIANA CHAMBER INSURANCE AGENCY3 Filed as: INDIANA CHAMBER INSURANCE INC | 115 W. WASHINGTON ST, SUITE 850 S INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES INC | $624 | — | $624 | 0.09% |
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 | 77 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 77 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES INC | 135 | $679K |
| Vision | ANTHEM INSURANCE COMPANIES INC | 135 | $679K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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."
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.