| 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 | $20K | $11K | $30K | 23.15% |
| USI INSURANCE SERVICES LLC3 | 550 PLEASTVILLE ROAD SUITE 160 SOUTH BRIARCLIFF MANOR, NY 10510 | DELTA DENTAL OF KENTUCKY | $4K | — | $4K | 3.60% |
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA INSURANCE COMPANY | $9K | $4K | $13K | 22.48% |
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $5K | $13K | 23.32% |
| USI INSURANCE SERVICES LLC3 | MIDWEST PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $10K | 22.40% |
| MARY DUFF3 | 1005 RICHMOND RD LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $873 | $4K | 13.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, FL 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $55 | $3K | 8.97% |
| ALICE RYAN STRIBLING3 | 511 KILBOURNE RD COLUMBIA, SC 29205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $776 | $232 | $1K | 3.24% |
| ANDREW JOSEPH SLATER3 | 1096 COOPER DR LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $181 | $1 | $182 | 0.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $47K | $2K | $49K | 193.91% |
| MARY DUFF3 | 1005 RICHMOND RD LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $235 | $1K | 10.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, FL 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $17 | $1K | 8.79% |
| ALICE RYAN STRIBLING3 | 511 KILBOURNE RD COLUMBIA, SC 29205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $336 | $98 | $434 | 3.46% |
| ANDREW JOSEPH SLATER3 | 1096 COOPER DR LEXINGTON, KY 40502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | $1 | $130 | 1.04% |
| MIKE TERRY3 | 1505 CASPER CT LEXINGTON, KY 40511 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.14% |
| MARGARET C TERRY3 | 1505 CASPER CT LEXINGTON, KY 40511 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KY, INC. EIN 61-1237516 ADMIN SERVICES | Float revenue; Other services; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $189K |
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 | 302 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 451 | $25K |
| Dental | DELTA DENTAL OF KENTUCKY | 475 | $103K |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 451 | $25K |
| Life insurance | UNITED OF OMAHA INSURANCE COMPANY | 302 | $58K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $132K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $46K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA INSURANCE COMPANY | 302 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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.