| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF INDIANA LLC | 10 E MAIN ST STE 400 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $49K | $10K | $59K | 14.78% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF IN LLC | 10 E MAIN ST STE 400 CARMEL, IN 46032 | METROPOLITIAN LIFE INSURANCE COMPANY | $16K | $3K | $20K | 5.89% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN, INC. | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 0.79% |
| 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 | — | $1.8M |
| UMR INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $101K |
| ASSURED PARTNERS OF IN LLC EIN 90-0927571 BROKER | Other commissions Service code 55 | — | $45K |
| 98POINT6 EIN 81-5231430 TELEDOC FEES | Claims processing; Contract Administrator Service code 12 | — | $17K |
| BHS EIN 52-1306404 EAP ADMIN | Contract Administrator; Claims processing Service code 12 | — | $12K |
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 | 685 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 700 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITIAN LIFE INSURANCE COMPANY | 874 | $332K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 489 | $55K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 685 | $398K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 685 | $398K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 685 | $398K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 685 | $398K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 874 | — |
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.