| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | ANTHEM INSURANCE COMPANIES, INC. | $131K | — | $131K | 2.95% |
| 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 | $10K | — | $10K | 12.00% |
| SUSAN MARIE BARD3 | 7219 DERSTAN RD INDIANAPOLIS, IN 46250 | AFLAC | $4K | $37 | $4K | 7.07% |
| MICHAEL ROBERT YURCZYK3 | 9616 WYOMING TER S BLOOMINGTON, MN 55438 | AFLAC | $641 | — | $641 | 1.10% |
| HOLLY RENEE ASHLEY3 | 720 S RANGELINE RD APT 419 CARMEL, IN 46032 | AFLAC | $409 | $9 | $418 | 0.71% |
| MICHAEL DUANE ARNOLD3 | 2147 BUTTONBUSH DR PLAINFIELD, IN 46168 | AFLAC | $363 | — | $363 | 0.62% |
| BRIANNA LYNN ROWE3 | 3386 CHALICE CT PLAINFIELD, IN 46168 | AFLAC | $333 | — | $333 | 0.57% |
| MARIA N VONDIELINGEN3 | 9912 RIDGE DR INDIANAPOLIS, IN 46250 | AFLAC | $309 | $9 | $318 | 0.54% |
| COURTNEY RYAN YURCZYK3 | 9616 WYOMING TER S MINNEAPOLIS, MN 55438 | AFLAC | $276 | — | $276 | 0.47% |
| BENJAMIN HUNTER3 | 18401 AVEBURY LN WESTFIELD, IN 46062 | AFLAC | $211 | — | $211 | 0.36% |
| DANIEL L EALY3 | 4955 KERRINGTON BLVD BARGERSVILLE, IN 46106 | AFLAC | $195 | — | $195 | 0.33% |
| LYDIA C CLARK3 | 11882 PINE MEADOW CIR FISHERS, IN 46037 | AFLAC | $150 | — | $150 | 0.26% |
| DAVID W SCOTT3 | 131 E EXCHANGE AVE STE 128 FORT WORTH, TX 76164 | AFLAC | $147 | — | $147 | 0.25% |
| ROGER HUGH JONES3 | 10524 IBIS RESERVE CIR WEST PALM BEACH, FL 33412 | AFLAC | $117 | — | $117 | 0.20% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $95 | — | $95 | 0.16% |
| VICKIE SUE MASTERS3 | 14012 THEODORA LN ALEDO, TX 76008 | AFLAC | $58 | — | $58 | 0.10% |
| JOHN L RADTKE3 | 4524 E FOXMOOR LN LAFAYETTE, IN 47905 | AFLAC | $55 | — | $55 | 0.09% |
| BRANDEE L JUSTUS3 | 5700 VICTORIA BLUFFS DR NEWBURGH, IN 47630 | AFLAC | $33 | — | $33 | 0.06% |
| MARY L WILLIAMS3 | 1102 STEVENS ST STE 1 BRIDGEPORT, TX 76426 | AFLAC | $32 | — | $32 | 0.05% |
| JULIE ANN RADTKE3 | 4524 E FOXMOOR LN LAFAYETTE, IN 47905 | AFLAC | $29 | — | $29 | 0.05% |
| JON J SCHAEFER3 | 7352 W BEYERS CT NEW PALENSTINE, IN 46163 | AFLAC | $28 | — | $28 | 0.05% |
| MATTHEW A COOK3 | 10069 BENT TREE LN FISHERS, IN 46037 | AFLAC | $22 | — | $22 | 0.04% |
| ASHLEY LYNN SHAW3 | 603 E WASHINGTON ST STE 100 INDIANAPOLIS, IN 46204 | AFLAC | $21 | — | $21 | 0.04% |
| MARK A WOJDA3 | 16258 DOGWOOD LN PLYMOUTH, IN 46563 | AFLAC | $20 | — | $20 | 0.03% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $20 | — | $20 | 0.03% |
| NFP INSURANCE SERVICES INC3 Filed as: APEX BENEFITS GROUP INC | 9400 PRIORITY WAY WEST DR INDIANAPOLIS, IN 46240 | AFLAC | $19 | — | $19 | 0.03% |
| AMY N GEHLHAUSEN3 | 3115 HOWARD DR JASPER, IN 47546 | AFLAC | $18 | — | $18 | 0.03% |
| MATTHEW D SMITH3 | 6655 MICHAEL DR CINCINNATI, OH 45243 | AFLAC | $14 | — | $14 | 0.02% |
| KAREN L WEBB3 | 5359 BROADWAY ST INDIANAPOLIS, IN 46220 | AFLAC | $14 | — | $14 | 0.02% |
| TIMOTHY B ASBY3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $11 | — | $11 | 0.02% |
| JASON A NAVILLE3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $10 | — | $10 | 0.02% |
| FRAN C HARGARTEN III3 | 1140 MOSSY ROCK RD NW KENNESAW, GA 30152 | AFLAC | $5 | — | $5 | 0.01% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $5 | — | $5 | 0.01% |
| KEVIN F WARD3 | 12632 DOUBLE EAGLE DR CARMEL, IN 46033 | AFLAC | $3 | — | $3 | 0.01% |
| KATIE J FLETCHER3 | 21263 STATE HIGHWAY 148 MARYVILLE, MO 64468 | AFLAC | $2 | — | $2 | 0.00% |
| JAMES M FLETCHER3 | 7325 CLUBHOUSE DR FORT WAYNE, IN 46835 | AFLAC | $2 | — | $2 | 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 | $7K | — | $7K | 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 | $6K | — | $6K | 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 | $1K | — | $1K | 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 | — | $27 | $27 | — |
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 | 314 | 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) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 554 | $4.4M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 554 | $4.4M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 554 | $4.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 314 | $58K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 314 | $87K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 314 | $48K |
| Other(4 contracts, 2 carriers) | AFLAC | 314 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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.