| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE, INC. | PO BOX 3430 CARMEL, IN 46082 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 1.28% |
| MJ INSURANCE3 Filed as: MJ INSURANCE, INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 85018 | DELTA DENTAL OF ARIZONA | $11K | $0 | $11K | 9.82% |
| PAYCOR INC3 Filed as: PAYCOR, INC | PO BOX 639860 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 6.86% |
| MJ INSURANCE3 Filed as: MJ INSURANCE, INC. | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.21% |
| MJ INSURANCE3 Filed as: MJ INSURANCE, INC. | PO BOX 3430 CARMEL, IN 46082 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.93% |
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 | 291 | 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) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 120 | $596K |
| Dental | DELTA DENTAL OF ARIZONA | 414 | $117K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 304 | $29K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 402 | $117K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 402 | $117K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 402 | $117K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 120 | $596K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 402 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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."
No prospect flags tripped on this filing.