| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 323 W LAKESIDE AVE. SUITE 410 CLEVELAND, OH 44113 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $20K | — | $20K | 2.37% |
| SKYLINE TERRACE LLC3 | 1246 S THIRD STREET LOUISVILLE, KY 40203 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $2K | — | $2K | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF KENTUCKY | $3K | — | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $257 | $5K | 16.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 650 EAST CARMEL DRIVE CARMEL, IN 46032 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $113 | $2K | $2K | 7.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $228 | $4K | 16.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 650 EAST CARMEL DRIVE CARMEL, IN 46032 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48 | $2K | $2K | 7.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $204 | $3K | 16.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 650 EAST CARMEL DRIVE CARMEL, IN 46032 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 7.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 1246 S 3RD ST LOUISVILLE, KY 40203 | RELIASTAR LIFE INSURANCE CO | $2K | — | $2K | 10.00% |
| BENE RE LLC3 | 5217 MONROE ST TOLEDO, OH 43623 | RELIASTAR LIFE INSURANCE CO | — | $1K | $1K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF KENTUCKY | $828 | — | $828 | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 650 EAST CARMEL DRIVE CARMEL, IN 46032 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10 | $415 | $425 | 7.39% |
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 | 120 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 119 | $832K |
| Dental | DELTA DENTAL OF KENTUCKY | 119 | $34K |
| Vision | DELTA DENTAL OF KENTUCKY | 99 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 136 | $21K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 28 | $19K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 95 | $27K |
| Other(5 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 154 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.