| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS5 Filed as: ZENITH AMERICAN SOLUTIONS INC. | 5420 W. SOUTHERN AVE. INDIANAPOLIS, IN 462415569 | HUMANA INSURANCE COMPANY | $138K | — | $138K | 3.99% |
| ZENITH AMERICAN SOLUTIONS5 Filed as: ZENITH AMERICAN SOLUTIONS INC. | 5420 W. SOUTHERN AVE. INDIANAPOLIS, IN 462415569 | HUMANA BENEFIT PLAN OF ILLINOIS INC | $23K | — | $23K | 4.07% |
| ZENITH AMERICAN SOLUTIONS5 Filed as: ZENITH AMERICAN SOLUTIONS INC. | 5420 W. SOUTHERN AVE. INDIANAPOLIS, IN 462415569 | HUMANA INSURANCE COMPANY | $900 | — | $900 | 3.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $1.3M |
| ZENITH AMERICAN SOLUTIONS INC. EIN 52-1590516 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Insurance brokerage commissions and fees; Other insurance fees and expenses Service code 12 | — | $677K |
| HORIZON ACTUARIAL SERVICES LLC EIN 26-1370698 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $221K |
| DELTA DENTAL PLAN OF INDIANA EIN 35-1545647 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $118K |
| HAZEL COMPTON EIN 35-6028684 EMPLOYEE | Plan Administrator; Employee (plan); Direct payment from the plan Service code 14 | — | $115K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 20-8764829 NONE | Investment advisory (plan); Investment management fees paid indirectly by plan; Other commissions; Custodial (securities); Investment management fees paid directly by plan; Securities brokerage commissions and fees; Other services; Securities brokerage; Other fees; Recordkeeping fees; Other investment fees and expenses; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $97K |
| LEDBETTER PARISI, LLC EIN 03-0599899 NONE | Legal; Direct payment from the plan Service code 29 | — | $64K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $61K |
| CYNTHIA PITMAN EIN 35-6028684 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $49K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $46K |
| LILLIAN FOGHT EIN 35-6028684 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| AMANDA KELLER EIN 35-6028684 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $39K |
| KMR SYSTEMS EIN 13-3192128 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $28K |
| NAT'L EMPLOYEE BENEFITS ADMIN-NEBA EIN 65-0498809 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Direct payment from the plan Service code 12 | — | $25K |
| FIFTH THIRD BANK EIN 31-0676865 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $15K |
| EZ MAILING, LLC EIN 47-1320725 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $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 | 2,630 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,177 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,807 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 1,256 | $4.0M |
| Dental | HUMANA DENTAL INSURANCE COMPANY | 1,007 | $490K |
| Vision | HUMANA INSURANCE COMPANY | 1,007 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,256 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.