| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | KAISER FOUNDATION HEALTH PLAN INC | $67K | $0 | $67K | 2.84% |
| MJ INSURANCE3 | 571 MONON TRAIL CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | $4K | $20K | 17.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $7K | $13K | 12.36% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 Filed as: BOON CHAPMAN BNFT ADMNSTRS | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $6K | $6K | 5.07% |
| HOME OFFICE TPA PAYS COMMISSION3 | 475 FALLBROOK BOULEVARD LINCOLN, NE 68521 | AMERITAS LIFE INSURANCE CORPORATION | $4K | $0 | $4K | 14.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $1K | $1K | 4.41% |
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $86 | $93 | $179 | 1.57% |
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 | 682 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 129 | $2.4M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 209 | $109K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 453 | $25K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 682 | $120K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 209 | $109K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 129 | $2.4M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 682 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.