| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 11611 NORTH MERIDIAN STREET CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $7K | $7K | 7.20% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $79 | $79 | 0.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM INSURANCE COMPANIES, INC. | $5K | $40K | $44K | 54.59% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | PO BOX 955909 ST. LOUIS, MO 63195 | ANTHEM INSURANCE COMPANIES, INC. | $0 | $1K | $1K | 1.40% |
| MICHAEL C CARTER3 Filed as: MICHAEL C. CARTER | 1313 LAKE MEADOW DRIVE INDIANAPOLIS, IN 46217 | AFLAC | $2K | $0 | $2K | 4.69% |
| RITA J ABRAM3 Filed as: RITA J. ABRAM | 11500 GOLDEN WILLOW COURT ZIONSVILLE, IN 46077 | AFLAC | $1K | $0 | $1K | 2.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC & AGENTS | 9910 DUPONT CIRCLE DRIVE EAST SUITE 120 FORT WAYNE, IN 46825 | AFLAC | $1K | $0 | $1K | 2.31% |
| ROBERT W BURGETT3 Filed as: ROBERT W. BURGETT | 1701 WEST 18TH STREET, SUITE A INDIANAPOLIS, IN 46202 | AFLAC | $673 | — | $673 | 1.27% |
| CANDACE Y HILDEBRAN3 Filed as: CANDACE Y. HILDEBRAN | 864 HEATHERWOOD DRIVE GREENWOOD, IN 46143 | AFLAC | $230 | $0 | $230 | 0.43% |
| PHYLLIS A BEX3 Filed as: PHYLLIS A. BEX | 118 STONEYBROOK DRIVE GREENWOOD, IN 46142 | AFLAC | $197 | $0 | $197 | 0.37% |
| GERARD J. GRABLE3 | 30 VALLEY BLUFF LANE SIMPSONVILLE, SC 29680 | AFLAC | $191 | $0 | $191 | 0.36% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $116 | $2K | 5.29% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $92 | $92 | 0.20% |
| JOHN W DRAY3 Filed as: JOHN W. DRAY | 2155 GLENHURST DRIVE SNELLVILLE, GA 30078 | AFLAC | $2K | $220 | $3K | 13.60% |
| KIMBERLY A CARL3 Filed as: KIMBERLY A. CARL | 111 TARTAN DRIVE GREENSBURG, PA 15601 | AFLAC | $290 | $51 | $341 | 1.83% |
| ANCILLARY BENEFITS CONSULTING LLC3 Filed as: ANCILLARY BENEFITS CONSULTING, LLC | 125 TECHNOLOGY DRIVE, SUITE 201 CANONSBURG, PA 15317 | AFLAC | $272 | $51 | $323 | 1.73% |
| SUSAN L. NELSON3 Filed as: SUSAN L. NELSON AND OTHER AGENTS | 821 LOIS DRIVE NEW KENSINGTON, PA 15068 | AFLAC | $101 | $0 | $101 | 0.54% |
| JEFFREY CORREAL3 | 442 DUCK HOLLOW ROAD UNIONTOWN, PA 15401 | AFLAC | $76 | $0 | $76 | 0.41% |
| MICHAEL A. BITTEL3 Filed as: MICHAEL ANTHONY BITTEL | 129 MARION DRIVE CANONSBURG, PA 15317 | AFLAC | $63 | $0 | $63 | 0.34% |
| JAMES BRADLEY SEIFERT3 | 157 MCCOY PLACE ROAD SEWICKLEY, PA 15143 | AFLAC | $29 | $0 | $29 | 0.16% |
| USI INSURANCE SERVICES LLC3 | 15350 25TH AVENUE NORTH, SUITE 114 PLYMOUTH, MN 55447 | HIGHMARK INC. | $397 | $0 | $397 | 3.34% |
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 | 255 | 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) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 231 | $127K |
| Vision(2 contracts, 2 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 231 | $93K |
| Life insurance(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 255 | $167K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 255 | $95K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 255 | $167K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.