| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIANA CHAMBER INSURANCE AGENCY3 Filed as: INDIANA STATE MEDICAL ASSOC | 322 CANAL WALK INDIANAPOLIS, IN 46202 | ANTHEM INSURANCE COMPANIES, INC. (G2001) | $94 | — | $94 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC EIN 35-0781558 NONE | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $765K |
| INDIANA STATE MEDICAL ASSOC INS AGY EIN 35-1731389 NONE | Insurance services Service code 23 | — | $280K |
| EPIPHANYRX EIN 04-3608530 NONE | Claims processing Service code 12 | — | $205K |
| LHD BENEFITS ADVISORS EIN 35-2150902 NONE | Consulting (general) Service code 16 | — | $118K |
| MILLIMAN, INC. EIN 91-0675641 NONE | Actuarial Service code 11 | — | $98K |
| BOSE, MCKINNEY & EVANS LLP EIN 35-0957980 NONE | Legal Service code 29 | — | $73K |
| CLK SOLUTIONS, LLC EIN 87-2050867 CONSULTANT | Consulting (general) Service code 16 | — | $40K |
| VITAL INCITE, LLC EIN 82-3614359 NONE | Consulting (general) Service code 16 | — | $28K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $25K |
| BRADY WARE RKN EIN 34-1476702 AUDITOR | Accounting (including auditing) Service code 10 | — | $24K |
| NEW AVENUES, INC. EIN 35-2095998 NONE | Other services Service code 49 | — | $18K |
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 | 836 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 842 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. (G2001) | 1,810 | $1.2M |
| Dental | DELTA DENTAL OF INDIANA | 0 | $398K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. (G2001) | 1,810 | $1.2M |
| Prescription drug | EPIPHANYRX | 1,810 | $2.8M |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. (G2001) | 1,810 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,810 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.