| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK ROAD FARMINGTON, CT 06032 | ANTHEM INSURANCE COMPANIES, INC. | $31K | $2K | $33K | 2.28% |
| LOCKTON COMPANIES, LLC3 | UNKNOWN LEBANON, IN 46052 | ANTHEM INSURANCE COMPANIES, INC. | $1K | $82 | $1K | 0.09% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $226 | $7K | 9.45% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE, SUITE 510 CHARLOTTE, NC 28210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.87% |
| SUSAN MARIE BARD3 | 7219 DERSTAN ROAD INDIANAPOLIS, IN 46250 | AFLAC | $6K | $211 | $6K | 13.36% |
| DANIEL L EALY3 Filed as: DANIEL L. EALY | 4955 KERRINGTON BOULEVARD BARGERSVILLE, IN 46106 | AFLAC | $1K | — | $1K | 2.15% |
| BRIANNA LYNN ROWE3 | 410 DUNN STREET PLAINFIELD, IN 46168 | AFLAC | $787 | $42 | $829 | 1.76% |
| MJ INSURANCE3 Filed as: COURTNEY YURCZYK AND VARIOUS AGENTS | 701 NORTH 2ND STREET APARTMENT 602 MINNEAPOLIS, MN 55401 | AFLAC | $638 | $42 | $680 | 1.44% |
| MICHAEL ROBERT YURCZYK3 | 5810 WEST 78TH STREET, SUITE 210 EDINA, MN 55439 | AFLAC | $668 | — | $668 | 1.42% |
| MICHAEL DUANE ARNOLD3 | 2601 FORTUNE CIRCLE EAST SUITE 103A INDIANAPOLIS, IN 46241 | AFLAC | $445 | — | $445 | 0.94% |
| LYDIA C CLARK3 Filed as: LYDIA C. CLARK | 11882 PINE MEADOW CIRCLE FISHERS, IN 46037 | AFLAC | $332 | $42 | $374 | 0.79% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 314 | $1.4M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 314 | $1.4M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 314 | $1.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $70K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $70K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $70K |
| Prescription drug | ANTHEM INSURANCE COMPANIES, INC. | 314 | $1.4M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.