| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $8K | $27K | 21.56% |
| USI INSURANCE SERVICES LLC3 | 550 PLEASTVILLE ROAD SUITE 160 SOUTH BRIARCLIFF MANOR, NY 10510 | DELTA DENTAL OF KENTUCKY | $4K | — | $4K | 3.58% |
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA INSURANCE COMPANY | $10K | $4K | $14K | 20.81% |
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $4K | $12K | 21.64% |
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 20.77% |
| MARY DUFF3 | 1005 RICHMOND RD LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $3K | $8K | 18.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, FL 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $149 | $4K | 10.00% |
| ALICE RYAN STRIBLING3 | 511 KILBOURNE RD COLUMBIA, SC 29205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $254 | $1K | 2.95% |
| ANDREW JOSEPH SLATER3 | 1096 COOPER DR LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $50K | $3K | $53K | 204.12% |
| MARY DUFF3 | 1005 RICHMOND RD LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 18.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, FL 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $57 | $2K | 9.73% |
| ALICE RYAN STRIBLING3 | 511 KILBOURNE RD COLUMBIA, SC 29205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $406 | $102 | $508 | 3.01% |
| MARGARET C TERRY3 | 1505 CASPER CT LEXINGTON, KY 40511 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.13% |
| MIKE TERRY3 | 1505 CASPER CT LEXINGTON, KY 40511 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.07% |
| ANDREW JOSEPH SLATER3 | 1096 COOPER DR LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KY, INC. EIN 61-1237516 ADMIN SERVICES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $223K |
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 | 349 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 478 | $26K |
| Dental | DELTA DENTAL OF KENTUCKY | 496 | $104K |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 478 | $26K |
| Life insurance | UNITED OF OMAHA INSURANCE COMPANY | 349 | $66K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $123K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 348 | $53K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA INSURANCE COMPANY | 349 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 496 | — |
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.