Form 5500 · Employee benefit plan · SEYMOUR, IN
JACKSON COUNTY BANK
JACKSON COUNTY BANK of SEYMOUR, IN is a 194-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is ERTEL & COMPANY, INC.. Coverage is written through SIHO INSURANCE SERVICES and 3 other carriers. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-0418300 · plan 503 · as of Aug 2026
Plan brief
Schedule A lists 6 insured contracts covering health, dental, vision, life and disability; the largest, with SIHO INSURANCE SERVICES, covers 191 people.
Reported premium across the insured contracts is $1,593,314, with $58,506 in disclosed broker commissions — about 3.7% of premium.
The health contract's policy period ended in April, while at least one ancillary line renews in December — the plan is on a split renewal cycle.
ERTEL & COMPANY, INC. is the broker of record on 5 of the 6 contracts; the rest name a different broker or none.
4 carriers appear on the filing — SIHO INSURANCE SERVICES, DELTA DENTAL OF INDIANA, UNITED OF OMAHA LIFE INSURANCE COMPANY and VISION SERVICE PLAN — with SIHO INSURANCE SERVICES writing the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SIHO INSURANCE SERVICES | Health | 191 | April | $1,404,954 | $42,149 |
| DELTA DENTAL OF INDIANA | Dental | 198 | April | $77,481 | $5,116 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 199 | December | $49,817 | $3,991 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 174 | December | $24,318 | $3,182 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 60 | December | $20,677 | $3,102 |
| VISION SERVICE PLAN | Vision | 108 | April | $16,067 | $966 |
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