| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $59K | $0 | $59K | 13.86% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES, LLC | 1933 STATE ROUTE 35, SUITE 368 WALL TOWNSHIP, NJ 07719 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $21K | $0 | $21K | 5.00% |
| THE WORKSITE GROUP LLC3 Filed as: THE WORKSITE GROUP | 1900 POLARIS PARKWAY, SUITE 450 COLUMBUS, OH 43240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $11K | $11K | 2.61% |
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 | 231 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANY | 424 | $2.1M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $426K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $426K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $426K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $426K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $426K |
| Prescription drug | ANTHEM INSURANCE COMPANY | 424 | $2.1M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $426K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.