| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOGAN LAVELLE HUNT DBA3 | ASSOCIATION INSURANCE MARKETERS 5150 CHARLESTOWN ROAD NEW ALBANY, IN 47150 | ANTHEM INSURANCE COMPANIES, INC. | $178K | — | $178K | 1.66% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD STE 100 CARMEL, IN 46032 | ANTHEM INSURANCE COMPANIES, INC. | $135K | $230 | $136K | 1.26% |
| EMPLOYEE BENEFIT SOLUTIONS INC3 | PO BOX 19 MISHAWAKA, IN 46546 | ANTHEM INSURANCE COMPANIES, INC. | $4K | — | $4K | 0.03% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | ANTHEM INSURANCE COMPANIES, INC. | $957 | — | $957 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPSTONE ADMINISTRATORS LLC EIN 35-2260019 NONE | Direct payment from the plan; Plan Administrator Service code 14 | 6110 TECHNOLOGY CENTER DR INDIANAPOLIS, IN 46278 | $187K |
| ASSOCIATED BUILDERS AND CONTRACTORS EIN 23-7298705 NONE | Direct payment from the plan; Other services Service code 49 | 5001 N SHADELAND AVENUE INDIANAPOLIS, IN 46226 | $31K |
| L.M. HENDERSON & COMPANY, LLP EIN 20-5520612 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 450 E 96TH STREET STE 200 INDIANAPOLIS, IN 46240 | $12K |
| STOCK YARDS BANK & TRUST COMPANY EIN 61-0354170 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | 1040 EAST MAIN STREET LOUISVILLE, KY 40206 | $7K |
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 | 1,850 | 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) | 1,850 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 1,955 | $10.7M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 1,955 | $10.7M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 1,955 | $10.7M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 8 | $235 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,955 | — |
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."
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.