| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 7.43% |
| VMI ACQUISITION INC3 Filed as: VMI ACQUISITIONS INC | PO BOX 1779 BOWLING GREEN, KY 42102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $242 | $3K | 5.75% |
| DEBORAH S GOLDEN3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $963 | $108 | $1K | 2.08% |
| VIOLET P COOTS3 | 1870 PLANO RICHPOND RD BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $734 | $133 | $867 | 1.68% |
| LISA R GRAVES3 | 1400 GLENNS CREEK ROAD FRANKFORT, KY 40601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $713 | $95 | $808 | 1.57% |
| SUSAN MAE DANIEL3 | 363 PLEASANT PLACE WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $291 | — | $291 | 0.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 300 EAST MAIN ST STE 1300 NORFOLK, VA 23510 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $228 | — | $228 | 0.44% |
| FRANKIE GLEE WILLIAMS3 | 725 STEEPLECHASE WAY BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $170 | $25 | $195 | 0.38% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.13% |
| VAN METER INSURANCE AGCY INC3 | PO BOX 1779 BOWLING GREEN, KY 42102 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $471 | $9K | 21.12% |
| VAN METER INSURANCE AGCY INC3 | PO BOX 1779 BOWLING GREEN, KY 42102 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $418 | $8K | 21.04% |
| VAN METER INSURANCE AGENCY INC3 | 1240 FAIRWAY ST. BOWLING GREEN, KY 42103 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $379 | — | $379 | 2.33% |
| VAN METER INSURANCE AGCY INC3 | PO BOX 1779 BOWLING GREEN, KY 42102 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $166 | $3K | 21.05% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $652 | $304 | $956 | 7.76% |
| VMI ACQUISITION INC3 | PO BOX 1779 BOWLING GREEN, KY 42102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $670 | $62 | $732 | 5.94% |
| DEBORAH S GOLDEN3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $258 | $28 | $286 | 2.32% |
| VIOLET P COOTS3 | 1870 PLANO RICHPOND RD BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $218 | $35 | $253 | 2.05% |
| FRANKIE GLEE WILLIAMS3 | 725 STEEPLECHASE WAY BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $30 | $187 | 1.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 300 EAST MAIN ST STE 1300 NORFOLK, VA 23510 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.74% |
| LISA R GRAVES3 | 1400 GLENNS CREEK ROAD FRANKFORT, KY 40601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $11 | $91 | 0.74% |
| SUSAN MAE DANIEL3 | 363 PLEASANT PLACE WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.13% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.09% |
| VMI ACQUISITION INC3 | 1240 FAIRWAY ST BOWLING GREEN, KY 421021779 | HEALTH RESOURCES, INC. | $625 | — | $625 | 13.82% |
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 | 129 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | HEALTH RESOURCES, INC. | 311 | $5K |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 304 | $16K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 260 | $106K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $40K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $16K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 260 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.