| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF INDIANA LLC | 10401 N MERIDIAN ST SUITE 300 INDIANAPOLIS, IN 46290 | THE GUARDIAN LIFE INSURANCE COMPANY | $78K | $8K | $85K | 16.42% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 27061 OAKMEAD DR PERRYSBURG, OH 43551 | THE GUARDIAN LIFE INSURANCE COMPANY | $39K | — | $39K | 7.61% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF INDIANA, LLC | 10 E MAIN ST STE 400 CARMEL, IN 46032 | VISION SERVICE PLAN | $2K | — | $2K | 2.45% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF INDIANA, LLC | 10401 N MERIDIAN ST #300 INDIANAPOLIS, IN 46290 | HCC LIFE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL LLC | 200 COLONIAL CENTER PKWY STE 140 LAKE MARY, FL 32746 | GUARDIAN LIFE INSURANCE COMPANY | — | $263 | $263 | 0.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $338K |
| ATHEM INSURANCE COMPANIES, INC. EIN 35-0781558 SERVICE FEE | Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $173K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 RX ADMIN | Contract Administrator; Claims processing Service code 12 | — | $31K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $19K |
| ASSUREDPARTNERS OF INDIANA LLC BROKER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 9247 N MERIDIAN ST STE 300 INDIANAPOLIS, IN 46260 | $15K |
| INGENIORX INC. EIN 82-3062245 RX FEES | Contract Administrator; Claims processing; 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 | 651 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 654 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 439 | $102K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 651 | $519K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY | 574 | $43K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 651 | $519K |
| Other | HCC LIFE INSURANCE COMPANY | 512 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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.