| 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 | 4.12% |
| INDIANA CHAMBER INSURANCE AGENCY IN3 | 115 WEST WASHINGTON ST SUITE 850S INDIANAPOLIS, IN 46204 | ANTHEM INSURANCE COMPANIES, INC. | $500 | — | $500 | 0.09% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $3K | $8K | 19.02% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $91 | $2K | 20.96% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $473 | — | $473 | 5.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 257 N CALDERWOOD STREET 357 ALCOA, TN 37701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $473 | — | $473 | 5.00% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADISONVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $55 | $1K | 15.74% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $370 | — | $370 | 5.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 257 N CALDERWOOD STREET 357 ALCOA, TN 37701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $370 | — | $370 | 5.00% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $45 | $1K | 20.83% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $603 | — | $603 | 9.91% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 257 N CALDERWOOD STREET 357 ALCOA, TN 37701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $304 | — | $304 | 4.99% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $51 | $1K | 20.96% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $265 | — | $265 | 4.99% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 257 N CALDERWOOD STREET 357 ALCOA, TN 37701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $265 | — | $265 | 4.99% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $497 | $36 | $533 | 16.08% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $166 | — | $166 | 5.01% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 257 N CALDERWOOD STREET 357 ALCOA, TN 37701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $166 | — | $166 | 5.01% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADINSVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $431 | $19 | $450 | 20.99% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE AND BENEFITS GRO | 13800 JACKSON RD MISHAWAKA, IN 46544 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $212 | — | $212 | 9.89% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 257 N CALDERWOOD STREET 357 ALCOA, TN 37701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $107 | — | $107 | 4.99% |
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 | 312 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 99 | $544K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $44K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $44K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $44K |
| Other(7 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 312 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.