| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF INDIANA LLC | 10401 N MERIDIAN ST STE 300 CARMEL, IN 46290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $41K | — | $41K | 11.94% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF INDIANA LLC | 4500 TOWN CENTER BLVD #200 JEFFERSONVILLE, IN 47130 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 2.62% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF IN LLC | 10401 N MERDIAN ST STE 300 INDIANAPOLIS, IN 46290 | METROPOLITIAN LIFE INSURANCE COMPANY | $25K | $2K | $27K | 9.07% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN, INC. | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITIAN LIFE INSURANCE COMPANY | $422 | — | $422 | 0.14% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF INDIANA LLC | 9247 NORTH MERIDIAN STREET SUITE 20 INDIANAPOLIS, IN 46260 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.06% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER ROAD LOUISVILLE, KY 40206 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $817 | $817 | 1.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC. EIN 33-0441200 RX BENEFIT MANAGEMENT | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $1.2M |
| UMR INC. EIN 39-1995276 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $106K |
| ASSURED PARTNERS OF IN LLC EIN 90-0927571 BROKER | Other commissions Service code 55 | — | $43K |
| 98POINT6 EIN 47-3490194 TELEDOC | Contract Administrator; Claims processing Service code 12 | — | $15K |
| BHS EIN 52-1306404 EAP ADMIN | Contract Administrator; Claims processing Service code 12 | — | $13K |
| UMR INC, EIN 39-1995276 COBRA | Contract Administrator; Claims processing Service code 12 | — | $6K |
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 | 649 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 77 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 728 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITIAN LIFE INSURANCE COMPANY | 866 | $355K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 445 | $55K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 649 | $342K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 649 | $342K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 649 | $342K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 649 | $342K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 866 | — |
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.