| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOUCHENS INSURANCE GROUP INC3 Filed as: HOUCHENS INSURANCE GROUP, INC. | 1750 SCOTTSVILLE ROAD SUITE 4 BOWLING GREEN, KY 42104 | HARTFORD LIFE AND ACCIDENT | $173K | — | $173K | 15.53% |
| HOUCHENS INSURANCE GROUP INC3 Filed as: HOUCHENS INSURANCE GROUP, INC. | PO BOX 1779 BOWLING GREEN, KY 42102 | HARTFORD LIFE AND ACCIDENT | — | $50K | $50K | 4.47% |
| HOUCHENS INSURANCE GROUP INC3 Filed as: HOUCHENS INSURANCE GROUP INC-- DINA | 1750 SCOTTSVILLE ROAD SUITE 4 BOWLING GREEN, KY 42104 | DELTA DENTAL OF KENTUCKY | $29K | — | $29K | 6.85% |
| HOUCHENS INSURANCE3 Filed as: HOUCHENS INS GROUP DBA VAN METER IN | 1750 SCOTTSVILLE ROAD SUITE 4 BOWLING GREEN, KY 42104 | VISION SERVICE PLAN | $10K | — | $10K | 10.31% |
| HOUCHENS INSURANCE GROUP INC3 | 1240 FAIRWAY STREET BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $3K | $11K | 43.48% |
| TED BENNETT3 | 1087 ARISTIDES DRIVE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $14 | $2K | 9.03% |
| HERBERT LAVON GRAHAM3 | 20787 STAFFORD STREET CLINTON TOWNSHIP, MI 48035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $515 | $2K | 7.65% |
| LEIGH L ARMSTRONG3 | 1330 WALNUT WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $986 | $391 | $1K | 5.42% |
| DEBORAH S GOLDEN3 | 1505 AQUARIUS WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $49 | $1K | 4.78% |
| FRANKIE GLEE WILLIAMS3 | 186 CHAMBERS DRIVE BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $848 | $267 | $1K | 4.39% |
| RONDA W. SCHELL3 Filed as: RONDA W SCHELL | 100 PROMENADE COURT LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $902 | — | $902 | 3.55% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN STREET MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $661 | — | $661 | 2.60% |
| KRISTIN BENNETT3 | 1462 HAMILTON COURT BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $506 | — | $506 | 1.99% |
| KAREN LYNN JOHNSTON3 | 20553 EMMETT STREET TAYLOR, MI 48180 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $308 | — | $308 | 1.21% |
| W F HILL AND ASSOCIATES INC3 | 30700 TELEGRAPH ROAD SUITE 2620 BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | $68 | $233 | 0.92% |
| JEREMY SAMPSEL3 | 401 HALL STREET SOUTHWEST SUITE 225 GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $98 | $190 | 0.75% |
| JESSICA ZABOROWSKI3 | 2760 OHIO STREET BETHEL PARK, PA 15102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | — | $114 | 0.45% |
| CRTX2 LLC3 | 826 ANN MARIE CIRCLE BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $48 | $98 | 0.39% |
| JT PREMIER HOLDINGS LLC3 | 2620 WINESAP DRIVE NORTHEAST GRAND RAPIDS, MI 49525 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $83 | $97 | 0.38% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DRIVE MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $9 | $36 | 0.14% |
| MARYANNE ANDERSON3 | 1014 EDGEFIELD WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.05% |
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 | 11 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 1,345 | $429K |
| Vision | VISION SERVICE PLAN | 680 | $96K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 837 | $1.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 837 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 837 | $1.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 837 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,345 | — |
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.