| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FEIGNER INSURANCE3 | 959 E 4TH ST MARION, IN 46952 | PRINCIPAL LIFE INSURANCE COMPANY | $22K | — | $22K | 14.94% |
| FEIGNER INSURANCE3 | PO BOX 1600 MARION, IN 46952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $21K | $4K | $25K | 18.00% |
| FEIGNER INSURANCE3 | PO BOX 1600 MARION, IN 46952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | $2K | $14K | 18.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $1.6M |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 225 S EAST ST INDIANAPOLIS, IN 46202 | $42K |
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 | 1,238 | 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) | 1,238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES,INC. | 1,238 | $736K |
| Vision | ANTHEM INSURANCE COMPANIES,INC. | 1,238 | $736K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 992 | $147K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 361 | $141K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 420 | $80K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES,INC. | 1,238 | $736K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,238 | — |
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.