| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVERENCE ASSOCIATION INC3 Filed as: EVERENCE ASSOCIATION, INC. | 1110 NORTH MAIN STREET PO BOX 483 GOSHEN, IN 46527 | MADISON NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 11.80% |
| NORTH AMERICAN BENEFITS COMPANY5 | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 8.05% |
| BURT ADVISORY GROUP3 Filed as: BURT ADVISORY GROUP, INC. | 307 S. MAIN ST. SUITE 302 ELKHART, IN 46516 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 7.28% |
| BUKATY COMPANIES3 | 4601 COLLEGE BLVD STE 100 LEAWOOD, KS 66211 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $1K | $9K | 27.92% |
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 | 175 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | MADISON NATIONAL LIFE INSURANCE COMPANY | 175 | $85K |
| Short-term disability(2 contracts, 2 carriers) | MADISON NATIONAL LIFE INSURANCE COMPANY | 175 | $85K |
| Long-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 175 | $51K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.