| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMPREHENSIVE BUSINESS INSURANCE3 | P.O. BOX 1485 CORBIN, KY 40702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 6.60% |
| LESLIE ANN FEATHERLY3 | 3022 HELENA ROAD FLEMINGSBURG, KY 41041 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.36% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY | 3008 ATKINSON AVENUE LEXINGTON, KY 40509 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.34% |
| THE HINTON AGENCY LLC3 | 121 EAST ELECTRIC AVENUE FLEMINGSBURG, KY 41041 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2 | $1K | 2.07% |
| THE BARDELL AGENCY3 | 424 CUNNINGHAM LANE LEXINGTON, KY 40508 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $885 | $17 | $902 | 1.29% |
| ANNE T. ALTIERI3 Filed as: ANNE TAVENNER ALTIERI | 1033 WHITEHALL PLACE LEXINGTON, KY 40517 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $317 | — | $317 | 0.45% |
| PENA ENTERPRISES INC3 | 2212 BELMONT DRIVE LEXINGTON, KY 40516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $213 | — | $213 | 0.30% |
| TIFFANY DAWN SMEDLEY3 | 4838 WATSON RD HILLSBORO, KY 41049 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $198 | — | $198 | 0.28% |
| JEFFREY L. PENA3 | 2212 BELMONT DRIVE LEXINGTON, KY 40516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $111 | — | $111 | 0.16% |
| MARSH & MCLENNAN AGENCY LLC3 | P.O. BOX 70 WEST POINT, GA 31833 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| ROTH VOLUNTARY BENEFIT SERVICES INC3 | 9 DEARBORN LANE BEAR, DE 19701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.01% |
| LAURA SUMIE CELIS GAMAS3 | 321 E CHARLESTOWN AVENUE JEFFERSONVILLE, IN 47130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| FULVIO A. ACOSTA3 Filed as: FULVIO A ACOSTA | 15017 WORTHINGTON ROAD PHILADELPHIA, PA 19116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| COMPREHENSIVE BUSINESS INSURANCE3 | P.O. BOX 1485 CORBIN, KY 40702 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 8.84% |
| COMPREHENSIVE BUSINESS INSURANCE3 | P.O. BOX 1485 CORBIN, KY 40702 | ANTHEM LIFE INSURANCE COMPANY | $474 | — | $474 | 15.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KY EIN 61-1237516 N/A | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing; Other services Service code 12 | — | $23K |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 0 | $0 |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 83 | $53K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 83 | $53K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 83 | $126K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 73 | $70K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 73 | $70K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 83 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 83 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.