| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | OPTIMA HEALTH PLAN | $13K | $0 | $13K | 2.00% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | OPTIMA HEALTH PLAN | $11K | $0 | $11K | 2.00% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | OHIC PPO | $9K | $0 | $9K | 2.00% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | OHIC PPO | $5K | $0 | $5K | 2.00% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | DELTA DENTAL OF VIRGINIA | $6K | $0 | $6K | 8.53% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN AND ASSOCIATES | 1933 STATE ROUTE 35, SUITE 368 WALL TOWNSHIP, NJ 07199 | DELTA DENTAL OF VIRGINIA | $3K | $0 | $3K | 5.03% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $1K | $0 | $1K | 2.98% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 22.16% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN AND ASSOCIATES | 1933 STATE ROUTE 35, SUITE 368 WALL TOWNSHIP, NJ 07199 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $4K | 10.50% |
| GIBSON INSURANCE AGENCY, INC.3 | 68986 EAGLE COVE COURT EDWARDSBURG, MI 46991 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 12.34% |
| GIBSON INSURANCE AGENCY, INC.3 | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | ANTHEM LIFE INSURANCE COMPANY | $945 | $0 | $945 | 9.90% |
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 | 318 | 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) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 252 | $1.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF VIRGINIA | 407 | $111K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 290 | $49K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 290 | $56K |
| Prescription drug(4 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 252 | $1.9M |
| Other(8 contracts, 6 carriers) | OPTIMA HEALTH PLAN | 318 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 407 | — |
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."
No prospect flags tripped on this filing.