| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $22K | $30K | 7.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $37K | $12K | $49K | 20.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OHIO, LLC | 1105 SCHROCK ROAD SUITE 500 COLUMBUS, OH 43229 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34K | — | $34K | 15.18% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER RD LOUISVILLE, KY 40206 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24K | — | $24K | 10.74% |
| SHAWN M COLIN3 Filed as: SHAWN MICHAEL COLIN | 1400 MAIN ST. APT 302 CLARKSVILLE, IN 47129 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 1.81% |
| BRANDEE L JUSTUS3 | 5700 VICTORIA BLUFFS DR. NEWBURGH, IN 47630 | CONTINENTAL AMERICAN INSURANCE COMPANY | $274 | — | $274 | 0.12% |
| KYLE ELLISON3 Filed as: KYLE REED ELLISON | 3524 ELMRIDGE DR. EVANSVILLE, IN 47711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $109 | — | $109 | 0.05% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | $8K | $30K | 20.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 200 W VINE STREET SUITE 300 LEXINGTON, KY 40507 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $14K | — | $14K | 9.98% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $2K | $8K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KY, INC. EIN 61-1237516 MED/RX ADMIN FEES | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator Service code 12 | — | $379K |
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 | 1,683 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 871 | $143K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,683 | $244K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $436K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 246 | $151K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,683 | $507K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,683 | — |
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.