| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON RD MISHAWAKA, IN 46544 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $112K | $112K | 3.63% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP LLC | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | PRINCIPAL LIFE INSURANCE COMPANY | $57K | $4K | $61K | 12.76% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON RD MISHAWAKA, IN 46544 | CONTINENTAL AMERICAN INSURANCE COMPANY | $70K | — | $70K | 41.72% |
| MARY CARMELA BERARDI3 Filed as: MARY BERARDI | 3617 BEATEN PATH LEXINGTON, KY 40509 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 2.95% |
| ALAN W FOSTER3 Filed as: ALAN FOSTER | 716 FRENCH RIVER RD LEXINGTONNOLENSVILLE, TN 405093713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.96% |
| JULIE ANN WITT3 | 826 OVERHILLS DR OLD HICKORY, TN 37138 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.69% |
| CHRISTOPHER L MILLER3 Filed as: CHRISTOPHER MILLER | 488 LEMONT DRIVE APT N235 NASVILLE, TN 37216 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.67% |
| HEATHER MAMMEN3 | 251 BIG EDDY RD FRANKFORT, KY 40601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.61% |
| LINDSEY HOSKINS3 | 801 E BRANNON RD UNIT 136 NICHOLASVILLE, KY 40356 | CONTINENTAL AMERICAN INSURANCE COMPANY | $840 | — | $840 | 0.50% |
| LAURA BETH KELLER3 | 445 MADISON POINT DR LEXINGTON, KY 40515 | CONTINENTAL AMERICAN INSURANCE COMPANY | $352 | — | $352 | 0.21% |
| JESSICA SWICK3 | 444 JIM FORSYTHE LANE HARRODSBURG, KY 40330 | CONTINENTAL AMERICAN INSURANCE COMPANY | $96 | — | $96 | 0.06% |
| THOMAS M WILLIAMSON3 Filed as: THOMAS M WILIAMSON | 129 WATERS HILL CIRCLE LEBANON, TN 37087 | CONTINENTAL AMERICAN INSURANCE COMPANY | $72 | — | $72 | 0.04% |
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 | 773 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 773 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 720 | $3.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 1,111 | $478K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 1,111 | $478K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,111 | $478K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,111 | $478K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,111 | $478K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 780 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,111 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.