| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUNTINGTON INSURANCE INC3 Filed as: HUNTINGTON INSURANCE | 221 SOUTH CHURCH ST BOWLING GREEN, KY 43042 | COMPANION LIFE INSURANCE | $285 | — | $285 | 1.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CHARLES BROWN | 1335 CENTERAL AVE ASHLAND, KY 41101 | COMPANION LIFE INSURANCE | $120 | — | $120 | 0.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC EIN 34-1450364 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $37K |
| HUNTINGTON INSURANCE EIN 34-1715613 NONE | Insurance agents and brokers Service code 22 | 221 SOUTH CHURCH ST BOWLING GREEN, KY 43042 | $8K |
| AMERICAN HEALTH DATA INSTITUE EIN 35-2045379 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $5K |
| CHARLES BROWN NONE | Insurance agents and brokers Service code 22 | 1335 CENTRAL AVENUE ASHLAND, KY 41101 | $5K |
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 | 152 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE | 152 | $18K |
| Life insurance | COMPANION LIFE INSURANCE | 152 | $18K |
| Other | COMPANION LIFE INSURANCE | 152 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.