| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | ANTHEM INSURANCE COMPANIES, INC. | $16K | — | $16K | 2.40% |
| JA BENEFITS LLC3 | PO BOX 159 BEDFORD, IN 47421 | ANTHEM INSURANCE COMPANIES, INC. | $7K | — | $7K | 1.03% |
| INDY CHAMBER LLC3 | 111 MONUMENT CIRCLE SUITE 1950 INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES, INC. | $362 | — | $362 | 0.06% |
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $5K | 7.98% |
| JA BENEFITS LLC3 | 1630 H STREET BEDFORD, IN 47421 | ANTHEM LIFE INSURANCE COMPANY | $292 | — | $292 | 6.50% |
| JA BENEFITS LLC3 | PO BOX 159 BEDFORD, IN 47421 | ANTHEM LIFE INSURANCE COMPANY | $119 | — | $119 | 2.65% |
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 | 131 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 87 | $653K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 96 | $66K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 96 | $66K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 129 | $71K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 129 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.