| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTINE GOSSER3 | 1750 W. ANDREW JOHNSON HIGHWAY MORRISTOWN, TN 37814 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $94K | — | $94K | 3.63% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP, LLC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | $18K | $5K | $23K | 25.78% |
| KEYSTONE INSURERS GROUP INC3 Filed as: KEYSTONE INSURERS GROUP, INC. | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP, LLC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | $11K | $3K | $15K | 25.97% |
| KEYSTONE INSURERS GROUP INC3 Filed as: KEYSTONE INSURERS GROUP, INC. | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP, LLC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | $9K | $3K | $12K | 25.88% |
| KEYSTONE INSURERS GROUP INC3 Filed as: KEYSTONE INSURERS GROUP, INC. | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP, LLC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | $9K | $3K | $12K | 26.21% |
| KEYSTONE INSURERS GROUP INC3 Filed as: KEYSTONE INSURERS GROUP, INC. | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP, LLC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | $6K | $2K | $7K | 25.85% |
| KEYST487893 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS & BENEFITS GROUP, LLC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | $4K | $1K | $6K | 26.78% |
| KEYST487893 | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE LINCOLN LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
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 | 264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 269 | $2.6M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 269 | $2.6M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 269 | $2.6M |
| Life insurance(2 contracts) | THE LINCOLN LIFE INSURANCE COMPANY | 298 | $104K |
| Short-term disability(3 contracts) | THE LINCOLN LIFE INSURANCE COMPANY | 299 | $137K |
| Long-term disability | THE LINCOLN LIFE INSURANCE COMPANY | 125 | $47K |
| Other(2 contracts) | THE LINCOLN LIFE INSURANCE COMPANY | 298 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.