| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $4K | $9K | 12.05% |
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | AMERICAN UNITED LIFE INSURANCE COMPANY | $4K | $2K | $6K | 24.75% |
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | SYMETRA LIFE INSURANCE COMPANY | $671 | $565 | $1K | 35.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, INC. EIN 36-3086057 NONE | Claims processing Service code 12 | 200 W. ADAMS ST SUITE 500 CHICAGO, IL 60606 | $22K |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $71K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $71K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 132 | $24K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 104 | $3K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 104 | $3K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 83 | $273K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 83 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.