| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ERTEL & COMPANY, INC.3 Filed as: ERTEL & COMPANY | 10945 CORK PLACE INDIANAPOLIS, IN 46236 | DELTA DENTAL OF INDIANA | $30K | $0 | $30K | 2.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF INDIANA | $8K | $0 | $8K | 0.61% |
| ASSET SUPERHEROES3 Filed as: ASSET SUPERHEROES, INC. & OTHERS | 525 EAST CENTER STREET WARSAW, IN 46580 | DELTA DENTAL OF INDIANA | $5K | $0 | $5K | 0.41% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | DELTA DENTAL OF INDIANA | $4K | $0 | $4K | 0.28% |
| ENROLLEASE3 Filed as: FIRST PERSON, INC. | 9000 KEYSTONE CROSSING, SUITE 910 INDIANAPOLIS, IN 46240 | DELTA DENTAL OF INDIANA | $3K | $0 | $3K | 0.20% |
| KEYSTONE INS & BNFTS GRP LLC3 Filed as: KEYSTONE INS. & BNFTS. GROUP, LLC | 1995 POINT TOWNSHIP DRIVE NORTHUMBERLAND, PA 17857 | DELTA DENTAL OF INDIANA | $2K | $0 | $2K | 0.17% |
| CLIPPINGER FINANCIAL GROUP LLC3 Filed as: CLIPPINGER FINANCIAL GROUP, LLC | 415 CROSSLAKE DRIVE, SUITE A EVANSVILLE, IN 47715 | DELTA DENTAL OF INDIANA | $2K | $0 | $2K | 0.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 36-2739571 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | — | $1.5M |
| NFP CORPORATE SERVICES, INC. EIN 35-2015501 NONE | Direct payment from the plan; Consulting (general); Plan Administrator Service code 14 | — | $773K |
| EXPRESS SCRIPT, INC. EIN 43-1420563 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $142K |
| WELLNESS IQ, INC. EIN 56-2676855 NONE | Other services; Direct payment from the plan Service code 49 | — | $104K |
| ALERA GROUP INC DBA VITAL INCITE EIN 82-3614359 NONE | Consulting (general) Service code 16 | — | $81K |
| BOSE MCKINNEY & EVANS LLP EIN 35-0957980 NONE | Legal; Direct payment from the plan Service code 29 | — | $75K |
| TAFT STETTINIUS & HOLLISTER LLP EIN 31-0541755 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $49K |
| THE HOWARD E NYHART COMPANY, INC EIN 35-0966414 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $37K |
| BRADY WARE & SCHOENFELD, INC. EIN 35-1476702 NONE | Accounting (including auditing) Service code 10 | — | $23K |
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 | 1,499 | 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) | 1,499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 3,523 | $1.3M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 2,874 | $151K |
| Life insurance(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,499 | $0 |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,499 | $0 |
| Long-term disability(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,499 | $0 |
| Prescription drug | ANTHEM BLUE CROSS BLUE SHIELD | 1 | $768 |
| Stop-loss / reinsurancereinsurance | EXCESS REINSURANCE UNDERWRITERS | 2,911 | $4.2M |
| Other(10 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,499 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,523 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.