| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FISHCO INC3 | 227 N LYNN ST BRYAN, OH 43506 | AFLAC | $2K | — | $2K | 5.42% |
| ROBERT J LAWRENCE3 | 15409 SPENCERVILLE RD GRABILL, IN 46741 | AFLAC | $837 | $93 | $930 | 3.02% |
| MICHELLE L SEXTON3 | 12302 HUMMINGBIRD CV FORT WAYNE, IN 46845 | AFLAC | $589 | $201 | $790 | 2.57% |
| JUSTIN D HARPER3 | 10007 NORTHBROOK VALLEY DR APT 10 FORT WAYNE, IN 46825 | AFLAC | $308 | $78 | $386 | 1.25% |
| DONALD E SPRINGER3 | 3670 SUN STONE WAY NEW HAVEN, IN 46774 | AFLAC | $385 | — | $385 | 1.25% |
| TERRY J SILVERS3 Filed as: TERRY SEILER | 1652 HOWELL ST FORT WAYNE, IN 46808 | AFLAC | $277 | $88 | $365 | 1.19% |
| ENRIQUE BARRANCO PEREZ3 | 58915 BREMEN HWY MISHAWAKA, IN 46544 | AFLAC | $236 | $97 | $333 | 1.08% |
| MELISSA HAMRICK3 | 903 N 10TH ST DECATUR, IN 46733 | AFLAC | $226 | — | $226 | 0.73% |
| TIMOTHY GUY HICKS3 | 509 W 6TH ST MILFORD, IN 46542 | AFLAC | $98 | $22 | $120 | 0.39% |
| DERRICK T JACKSON3 | 701 W PACKARD AVE FORT WAYNE, IN 46807 | AFLAC | $113 | — | $113 | 0.37% |
| RICHARD UHRICK3 Filed as: RICHARD E UHRICK | PO BOX 93 LAOTTO, IN 46763 | AFLAC | $96 | — | $96 | 0.31% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE LEEPER | 707 ASTER CT BOURBON, IN 46504 | AFLAC | $59 | $22 | $81 | 0.26% |
| DERRICK T JACKSON3 | PO BOX 10114 FORT WAYNE, IN 46850 | AFLAC | $65 | — | $65 | 0.21% |
| JUSTIN E FINTON3 | 112 S ANDERSON ST ELWOOD, IN 46036 | AFLAC | $57 | — | $57 | 0.19% |
| JOHNATHAN DAVID BESWARICK3 | 250 ESTATES DR GIBSONIA, PA 15044 | AFLAC | $50 | — | $50 | 0.16% |
| NICHOLAS DEAN SHIPE3 | 11037 BROADWAY STE C CROWN POINT, IN 46307 | AFLAC | $31 | — | $31 | 0.10% |
| MICHAEL MCEVOY3 Filed as: MICHAEL J MCEVOY | 201 TECUMSEH ST WARSAW, IN 46582 | AFLAC | $22 | — | $22 | 0.07% |
| NAVILLE & ASSOCIATES3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $17 | — | $17 | 0.06% |
| JEFFREY S HINES3 | 6225 SUGAR TREE PL FORT WAYNE, IN 46835 | AFLAC | $11 | — | $11 | 0.04% |
| PAUL FICK3 | 1649 EMERSON AVE FORT WAYNE, IN 46808 | AFLAC | $10 | — | $10 | 0.03% |
| DAVID R KREMER3 | 20330 CHATHAM HILLS BLVD WESTFIELD, IN 46074 | AFLAC | $9 | — | $9 | 0.03% |
| JEREMY JAY JOHNSON3 | 7263 BRAXTON DR NOBLESVILLE, IN 46062 | AFLAC | $8 | — | $8 | 0.03% |
| PAUL FICK3 | 6929 O DAY RD FORT WAYNE, IN 46818 | AFLAC | $7 | — | $7 | 0.02% |
| MATTHEW A COOK3 | 10069 BENT TREE LN FISHERS, IN 46037 | AFLAC | $4 | — | $4 | 0.01% |
| JOHN T CLANCY3 | 4025 PETE DYE BLVD CARMEL, IN 46033 | AFLAC | $4 | — | $4 | 0.01% |
| MARK A WOJDA3 | 16258 DOGWOOD LN PLYMOUTH, IN 46563 | AFLAC | $4 | — | $4 | 0.01% |
| RICHARD A SMOKER3 | PO BOX 608 ELKHART, IN 46515 | AFLAC | $3 | — | $3 | 0.01% |
| JENNIFER L MITCHEN3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $3 | — | $3 | 0.01% |
| FISHCO INC3 | 227 LYNN ST BRYAN, OH 43506 | DELTA DENTAL OF INDIANA | $2K | $86 | $2K | 10.38% |
| FISHCO INC3 | 227 LYNN ST BRYAN, OH 43506 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $86 | $1K | 10.76% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INS SERVICE | 2101 FLORENCE AVE CINCINNATI, OH 45206 | PRINCIPAL LIFE INSURANCE COMPANY | — | $614 | $614 | 5.86% |
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 | 115 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MERITAIN HEALTH | 41 | $28K |
| Dental | DELTA DENTAL OF INDIANA | 58 | $21K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 115 | $10K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 115 | $10K |
| Other | AFLAC | 56 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.