| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE & BENEFITS | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITEDHEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 4.06% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE & BENEFITS | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $3K | $11K | 18.32% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE & BENEFITS | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $345 | $9K | 15.36% |
| BARBARA J LAKE3 | 226 N HIGH STREET MORRISTOWN, IN 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $16 | $4K | 6.16% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $5 | $2K | 3.24% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $551 | $1K | $2K | 2.91% |
| GARY A INERSON3 | 12576 BLUE HOLLY DRIVE APT 12 NOBLESVILLE, IN 46060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.80% |
| JOE GORDON3 | 5417 WINTHROP AVENUE INDIANAPOLIS, IN 46220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $160 | $72 | $232 | 0.40% |
| ELIZABETH LOUISE FENDER3 | 335 S EMERSON AVENUE INDIANAPOLIS, IN 46219 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $223 | — | $223 | 0.38% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | — | $82 | 0.14% |
| MICHAEL R ACKERMAN3 | 435 DEVON PARK DRIVE WAYNE, PA 19087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $2 | $7 | 0.01% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE & BENEFITS | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE DENTAL CONCERN, INC | $99 | $8 | $107 | 11.16% |
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 | 144 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 230 | $775K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $62K |
| Vision | THE DENTAL CONCERN, INC | 7 | $959 |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $62K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.