| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $72K | — | $72K | 4.00% |
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | — | $22K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 300 EAST MAIN STREET, SUITE 300 NORFOLK, VA 23510 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 4.83% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $691 | $2K | 3.79% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH S. GOLDEN | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $905 | $68 | $973 | 1.71% |
| VIOLET P COOTS3 | 1870 PLANO RICHPOND ROAD BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $585 | $97 | $682 | 1.20% |
| MJ INSURANCE3 Filed as: FRANKIE WILLIAMS AND VARIOUS AGENTS | 725 STEEPLECHASE WAY BOWLING GREEN, KY 42103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $517 | $109 | $626 | 1.10% |
| MICHAEL J BOONE3 | 1302 CLEAR SPRINGS TRACE LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $610 | — | $610 | 1.07% |
| SUSAN MAE DANIEL3 | 363 PLEASANT PLACE WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $421 | — | $421 | 0.74% |
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | EYEMED VISION CARE | $2K | — | $2K | 10.07% |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 255 | $1.8M |
| Vision | EYEMED VISION CARE | 417 | $20K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 182 | $145K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 182 | $145K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 182 | $145K |
| Prescription drug | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 255 | $1.8M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 182 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.