| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | ANTHEM INSURANCE COMPANIES, INC. | $22K | — | $22K | 3.92% |
| INDIANA CHAMBER INSURANCE AGENCY IN3 | 115 WEST WASHINGTON ST SUITE 850S INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES, INC. | $451 | — | $451 | 0.08% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $3K | $8K | 17.04% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 19.99% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $381 | — | $381 | 5.01% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $381 | — | $381 | 5.01% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADISONVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $736 | — | $736 | 15.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $245 | — | $245 | 4.99% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $245 | — | $245 | 4.99% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $900 | — | $900 | 20.10% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $443 | — | $443 | 9.90% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $224 | — | $224 | 5.00% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $855 | — | $855 | 20.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $214 | — | $214 | 5.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $214 | — | $214 | 5.00% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $483 | — | $483 | 15.01% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $161 | — | $161 | 5.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $161 | — | $161 | 5.00% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $373 | — | $373 | 20.12% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $184 | — | $184 | 9.92% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $93 | — | $93 | 5.02% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | ANTHEM LIFE INSURANCE COMPANY | $64 | — | $64 | — |
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 | 302 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 92 | $564K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $47K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $47K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $47K |
| Other(7 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 302 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.