| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 125 HIGH STREET, 22ND FLOOR BOSTON, MA 02110 | ANTHEM INSURANCE COMPANIES, INC. | $100K | $427 | $100K | 1.36% |
| ASSUREDPARTNERS3 | 10 EAST MAIN STREET, SUITE 400 CARMEL, IN 46032 | ANTHEM INSURANCE COMPANIES, INC. | $82K | $0 | $82K | 1.12% |
| ASSUREDPARTNERS3 | 10401 NORTH MERIDIAN, SUITE 300 INDIANAPOLIS, IN 46290 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $0 | $22K | 6.22% |
| ALLIANT INSURANCE SERVICES, INC.3 | 101 PARK AVENUE, 12TH FLOOR NEW YORK, NY 10016 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $0 | $20K | 5.76% |
| SUSAN MARIE BARD3 Filed as: SUSAN BARD | 7219 DERSTAN ROAD INDIANAPOLIS, IN 46250 | AFLAC | $3K | $41 | $3K | 6.64% |
| MJ INSURANCE3 Filed as: DANIEL EALY AND VARIOUS AGENTS | 9183 NORTH WATSON MEADOWS LANE MOORESVILLE, IN 46158 | AFLAC | $1K | $0 | $1K | 2.44% |
| MICHAEL YURCZYK3 | 9616 WYOMING TERRACE SOUTH BLOOMINGTON, MN 55438 | AFLAC | $478 | $0 | $478 | 0.99% |
| HOLLY RENEE ASHLEY3 Filed as: HOLLY ASHLEY | 720 SOUTH RANGELINE ROAD APARTMENT 419 CARMEL, IN 46032 | AFLAC | $303 | $9 | $312 | 0.65% |
| MICHAEL DUANE ARNOLD3 Filed as: MICHAEL ARNOLD | 2147 BUTTONBUSH DRIVE PLAINFIELD, IN 46168 | AFLAC | $280 | $0 | $280 | 0.58% |
| BRIANNA LYNN ROWE3 Filed as: BRIANNA ROWE | 3386 CHALICE COURT PLAINFIELD, IN 46168 | AFLAC | $278 | $0 | $278 | 0.58% |
| MARIA N VONDIELINGEN3 Filed as: MARIA VONDIELINGEN | 9912 RIDGE DRIVE INDIANAPOLIS, IN 46256 | AFLAC | $250 | $9 | $259 | 0.54% |
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 | 499 | 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) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 770 | $7.4M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 770 | $7.4M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 770 | $7.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 499 | $352K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 499 | $352K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 499 | $352K |
| Prescription drug | ANTHEM INSURANCE COMPANIES, INC. | 770 | $7.4M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 499 | $408K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 770 | — |
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.