| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 33 EAST JEFFERSON P.O. BOX 610 PLYMOUTH, IN 46563 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $844 | $18K | 14.43% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE GROUP | P.O. BOX 610 PLYMOUTH, IN 465630610 | VISION SERVICE PLAN | $2K | — | $2K | 2.96% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 SOUTH MAIN STREET SUITE 400 SOUTH BEND, IN 46601 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $113 | — | $113 | 15.07% |
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 | 273 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 370 | $1.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF INDIANA | 469 | $126K |
| Vision | VISION SERVICE PLAN | 351 | $73K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $123K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $123K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 370 | $1.9M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 469 | — |
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.
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.