| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 10 EAST MAIN STREET, SUITE 400 CARMEL, IN 46032 | ANTHEM INSURANCE COMPANIES, INC. | $184K | $0 | $184K | 2.64% |
| ASSUREDPARTNERS3 | 435 WHITTINGTON PARKWAY, SUITE 300 LOUISVILLE, KY 40222 | ANTHEM INSURANCE COMPANIES, INC. | $0 | $463 | $463 | 0.01% |
| ASSUREDPARTNERS3 | 10401 NORTH MERIDIAN INDIANAPOLIS, IN 46290 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $42K | $0 | $42K | 11.97% |
| SUSAN MARIE BARD3 | 7219 DERSTAN ROAD INDIANAPOLIS, IN 46250 | AFLAC | $2K | $95 | $2K | 5.28% |
| COURTNEY RYAN YURCZYK3 Filed as: COURTNEY RYAN YURCZYK & OTHERS | 9616 WYOMING TER SOUTH MINNEAPOLIS, MN 55438 | AFLAC | $887 | $0 | $887 | 2.18% |
| MICHAEL ROBERT YURCZYK3 | 9616 WYOMING TER SOUTH BLOOMINGTON, MN 55438 | AFLAC | $387 | $0 | $387 | 0.95% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $242 | $0 | $242 | 0.59% |
| MICHAEL DUANE ARNOLD3 | 2147 BUTTONBUSH DRIVE PLAINFIELD, IN 46168 | AFLAC | $232 | $0 | $232 | 0.57% |
| HOLLY RENEE ASHLEY3 | 720 SOUTH RANGELINE ROAD APARTMENT 419 CARMEL, IN 46032 | AFLAC | $150 | $14 | $164 | 0.40% |
| DANIEL L EALY3 Filed as: DANIEL L. EALY | 9183 NORTH WATSON MEADOWS LANE MOORESVILLE, IN 46158 | AFLAC | $159 | $0 | $159 | 0.39% |
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 | 413 | 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) | 413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 725 | $7.0M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 725 | $7.0M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 725 | $7.0M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 413 | $390K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 413 | $349K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 413 | $349K |
| Prescription drug | ANTHEM INSURANCE COMPANIES, INC. | 725 | $7.0M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 413 | $397K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 725 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.