| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE SPECIALISTS LLC3 Filed as: INSURANCE SPECIALISTS, LLC | 1750 SCOTTSVILLE ROAD, SUITE 4 BOWLING GREEN, KY 42104 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $81K | $30K | $111K | 20.48% |
| INSURANCE SPECIALISTS LLC3 Filed as: INSURANCE SPECIALISTS, LLC | 1750 SCOTTSVILLE ROAD, SUITE 4 BOWLING GREEN, KY 42104 | VISION SERVICE PLAN | $3K | — | $3K | 2.32% |
| INSURANCE SPECIALISTS LLC3 Filed as: INSURANCE SPECIALISTS, LLC | 1750 SCOTTSVILLE ROAD, SUITE 4 BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $490 | $12K | 20.37% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $537 | $188 | $725 | 1.22% |
| MJ INSURANCE3 Filed as: HOWARD HOROWITZ AND VARIOUS AGENTS | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.15% |
| CLARICE R MIMS3 Filed as: CLARICE R. MIMS | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.08% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE MARIE STUEMKY | 10208 MIDDLE DARLEEN LEANDER, TX 78641 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.05% |
| EDGHILL ENTERPRISES LLC3 | 3403 EAST SEEBLING MILE ROAD GRAND ISLAND, NE 68801 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.05% |
| CHALSEE CANTRELL3 | 1007 THISTLE DRIVE MESQUITE, TX 75149 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.03% |
| RONALD CHAMBERS4 Filed as: RONALD H. CHAMBERS | 3281 PLATEAU PLACE CINCINNATI, OH 45241 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $685 | — | $685 | 14.72% |
| JOSEPH A. VALENTIC4 | 37679 JEROME DRIVE STERLING HEIGHTS, MI 48312 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $90 | — | $90 | 1.93% |
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 | 899 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 907 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 179 | $59K |
| Vision | VISION SERVICE PLAN | 562 | $131K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,099 | $542K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,099 | $542K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,099 | $542K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,099 | $606K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,099 | — |
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.