| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATES | PO BOX 217 BLOOMINGTON, IL 61702 | HEALTH ALLIANCE MEDICAL PLANS | $22K | — | $22K | 2.31% |
| MEDLINK INC3 | 2001 LAKE POINT WAY LOUISVILLE, KY 40223 | ANTHEM HEALTH PLANS OF KENTUCKY, INC | $28K | — | $28K | 3.94% |
| THOMPSON-FLETCHER INSURANCE AGENCY3 | 505 W. STEPHEN FOSTER AVE BARDSTOWN, KY 40004 | ANTHEM HEALTH PLANS OF KENTUCKY, INC | $2K | — | $2K | 0.26% |
| RANDY A BUTTS3 Filed as: RANDY ALLEN BUTTS | 2806 E EMPIRE BLOOMINGTON, IL 61704 | BLUE CROSS BLUE SHIELD OF FLORIDA (HMO) | $18K | — | $18K | 4.00% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATION LIFE AGENCY L | PO BOX 5190 BLOOMINGTON, IL 617025190 | METROPOLITAN LIFE INSURANCE COMPANY | $51K | — | $51K | 12.09% |
| GROUP INSURANCE SERVICES INC3 | PO BOX 901 NAPERVILLE, IL 605660901 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $4K | $24K | 5.64% |
| RANDY A BUTTS3 Filed as: RANDY ALLEN BUTTS | 2806 E. EMPIRE BLOOMINGTON, IL 61704 | BLUE CROSS BLUE SHIELD OF FLORIDA | $14K | — | $14K | 4.00% |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTH ALLIANCE MEDICAL PLANS | 169 | $2.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $424K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $424K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $424K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $424K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH ALLIANCE MEDICAL PLANS | 54 | $1.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $424K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,092 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.