| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | 312 ELM ST., 24TH FL CINCINNATI, OH 45202 | DELTA DENTAL OF KENTUCKY | $5K | — | $5K | 2.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM ST., 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $86 | $3K | 5.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 5.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM ST., 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $76 | $8K | 15.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 5.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 9.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | 312 ELM ST., 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $55 | $6K | 15.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | 312 ELM ST., 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $40 | $4K | 15.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM ST., 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $34 | $3K | 14.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.36% |
| LOUIS R FAIOLA3 Filed as: LOUIS J PANTALONE | CUSTOM BENEFITS PROGRAMS, INC. PO BOX 1116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $192 | — | $192 | 2.11% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $86 | $110 | 1.21% |
| JO ANN PANTALONE3 | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $102 | — | $102 | 1.12% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | WF MIDWEST REGION PO BOX 3727 NORFOLK, VA 23514 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.85% |
| MCKELVEY, PHILIP, NEILL3 | 600 W. LOVELAND AVE. STE. 5A LOVELAND, OH 45140 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Other services; Claims processing; Contract Administrator Service code 12 | — | $428K |
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 | 589 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 589 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 377 | $321K |
| Dental | DELTA DENTAL OF KENTUCKY | 991 | $203K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 373 | $50K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 589 | $98K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $54K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 116 | $44K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 377 | $271K |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 589 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 991 | — |
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.