| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST. 6TH FLOOR SAN DIEGO, CA 92101 | ANTHEM INSURANCE COMPANIES, INC. | $44K | — | $44K | 2.28% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | ANTHEM INSURANCE COMPANIES, INC. | $36K | — | $36K | 1.87% |
| SUSAN MARIE BARD3 | 7219 DERSTAN RD INDIANAPOLIS, IN 46250 | AFLAC | $5K | $120 | $5K | 8.77% |
| ROGER HUGH JONES3 | 2204 COMMERCE ST ALPHARETTA, GA 30009 | AFLAC | $893 | $155 | $1K | 1.74% |
| DAVID W SCOTT3 | 131 E EXCHANGE AVE STE 128 FORT WORTH, TX 76164 | AFLAC | $1K | — | $1K | 1.68% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE CT PLAINFIELD, IN 46168 | AFLAC | $667 | $24 | $691 | 1.15% |
| VICKIE SUE MASTERS3 | 1209 JUDY ST WHITE SETTLEMENT, TX 76108 | AFLAC | $635 | — | $635 | 1.06% |
| MICHAEL ROBERT YURCZYK3 | 9616 WYOMING TER S BLOOMINGTON, MN 55438 | AFLAC | $630 | — | $630 | 1.05% |
| BENJAMIN HUNTER3 | 18401 AVEBURY LN WESTFIELD, IN 46062 | AFLAC | $562 | $13 | $575 | 0.96% |
| MICHAEL DUANE ARNOLD3 | 2147 BUTTONBUSH DR PLAINFIELD, IN 46168 | AFLAC | $373 | — | $373 | 0.62% |
| COURTNEY RYAN YURCZYK3 | 9616 WYOMING TER S MINNEAPOLIS, MN 55438 | AFLAC | $281 | — | $281 | 0.47% |
| LYDIA C CLARK3 | 11882 PINE MEADOW CIR FISHERS, IN 46037 | AFLAC | $233 | — | $233 | 0.39% |
| DANIEL L EALY3 | 4955 KERRINGTON BLVD BARGERSVILLE, IN 46106 | AFLAC | $206 | — | $206 | 0.34% |
| MARY L WILLIAMS3 | 1102 STEVENS ST STE 1 BRIDGEPORT, TX 76426 | AFLAC | $197 | — | $197 | 0.33% |
| JOHN L RADTKE3 | 4524 E FOXMOOR LN LAFAYETTE, IN 47905 | AFLAC | $107 | $16 | $123 | 0.20% |
| FRAN C HARGARTEN III3 | 1140 MOSSY ROCK RD NW KENNESAW, GA 30152 | AFLAC | $103 | $6 | $109 | 0.18% |
| WILLIAM M WARDLAW JR3 | 5300 OAKBROOK PKWY STE 300 NORCROSS, GA 30093 | AFLAC | $78 | $23 | $101 | 0.17% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $94 | — | $94 | 0.16% |
| MELISSA HAMILTON3 | 1306 MADISON LN SE SMYRNA, GA 30080 | AFLAC | $54 | — | $54 | 0.09% |
| ASHLEY SHAW LLC3 | 2501 MADISON AVE INDIANAPOLIS, IN 46225 | AFLAC | $47 | — | $47 | 0.08% |
| BRANDEE L JUSTUS3 | 5700 VICTORIA BLUFFS DR NEWBURGH, IN 47630 | AFLAC | $30 | — | $30 | 0.05% |
| JULIE ANN RADTKE3 | 4524 E FOXMOOR LN LAFAYETTE, IN 47905 | AFLAC | $26 | $3 | $29 | 0.05% |
| MATTHEW A COOK3 | 10069 BENT TREE LN FISHERS, IN 46037 | AFLAC | $25 | — | $25 | 0.04% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $21 | — | $21 | 0.03% |
| MARK A WOJDA3 | 631 GREENFORD TRL W CARMEL, IN 46032 | AFLAC | $21 | — | $21 | 0.03% |
| BENJAMIN HUNTER3 | 11193 GUY ST FISHERS, IN 46038 | AFLAC | $20 | — | $20 | 0.03% |
| TIMOTHY B ASBY3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $20 | — | $20 | 0.03% |
| MATTHEW D SMITH3 | 11142 SAINT CHARLES PL CARMEL, IN 46033 | AFLAC | $17 | $3 | $20 | 0.03% |
| JON J SCHAEFER3 | 4900 WINSTON DR INDIANAPOLIS, IN 46226 | AFLAC | $19 | — | $19 | 0.03% |
| AMY N GEHLHAUSEN3 | 3115 HOWARD DR JASPER, IN 47546 | AFLAC | $18 | — | $18 | 0.03% |
| JOSHUA WILLIAM HAINES3 | 1056 DELLA ST SE MARIETTA, GA 30067 | AFLAC | $14 | — | $14 | 0.02% |
| SILAS J SMITH3 | 4323 CREST DR LAFAYETTE, IN 47905 | AFLAC | $11 | — | $11 | 0.02% |
| JASON A NAVILLE3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $9 | — | $9 | 0.01% |
| KEVIN F WARD3 | 12632 DOUBLE EAGLE DR CARMEL, IN 46033 | AFLAC | $6 | — | $6 | 0.01% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $5 | — | $5 | 0.01% |
| KATIE J FLETCHER3 | 21263 STATE HIGHWAY 148 MARYVILLE, MO 64468 | AFLAC | $3 | — | $3 | 0.00% |
| JAMES M FLETCHER3 | 254 JOHN ST AURORA, IN 47001 | AFLAC | $1 | — | $1 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 12.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 12.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 12.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $550 | — | $550 | 12.00% |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 412 | $1.9M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 179 | $138K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 412 | $1.9M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $25K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $42K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $26K |
| Prescription drug | ANTHEM INSURANCE COMPANIES, INC. | 412 | $1.9M |
| Other(2 contracts, 2 carriers) | AFLAC | 195 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 412 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.