| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 6.15% |
| USI INSURANCE SERVICES LLC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $10K | $10K | 3.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF KENTUCKY | $20K | — | $20K | 8.63% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.00% |
| USI INSURANCE SERVICES LLC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 5.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 NETWORK/TPA | Claims processing; Float revenue; Contract Administrator; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $518K |
| USI INS SERVICES LLC | Non-monetary compensation; Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $32K |
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 | 464 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 832 | $233K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 285 | $42K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 464 | $314K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 464 | $314K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 464 | $314K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 888 | $136K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 464 | $314K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 888 | — |
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.