Form 5500 · Employee benefit plan · MOORESVILLE, IN
CITIZENS BANK
Public Form 5500 records show how CITIZENS BANK of MOORESVILLE, IN, a finance and insurance employer, structures its employee benefits. Its broker of record is ERTEL & COMPANY, INC.. Coverage is written through ANTHEM INSURANCE COMPANIES, INC. and 1 other carrier. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-0227210 · plan 502 · as of Aug 2026
Plan brief
Schedule A lists 4 insured contracts covering health, dental, vision, life and disability; the largest, with ANTHEM INSURANCE COMPANIES, INC., covers 177 people.
Reported premium across the insured contracts is $848,120, with $39,609 in disclosed broker commissions — about 4.7% of premium.
The health contract's policy period ended in July, while at least one ancillary line renews in August — the plan is on a split renewal cycle.
ERTEL & COMPANY, INC. is the broker of record on all 4 contracts.
Two carriers split the book: ANTHEM INSURANCE COMPANIES, INC. and ANTHEM LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. | Health, Dental, Vision | 177 | July | $772,334 | $29,557 |
| ANTHEM LIFE INSURANCE COMPANY | Life, Disability | 0 | July | $65,875 | $8,004 |
| ANTHEM INSURANCE COMPANIES, INC. | — | 0 | August | $4,602 | $1,381 |
| ANTHEM LIFE INSURANCE COMPANY | Life, Disability | 0 | August | $5,309 | $667 |
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