| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EPIC3 Filed as: EPIC INS SOLUTIONS AGENCY, LLC | PO BOX 221649 LOUISVILLE, KY 40252 | HARTFORD LIFE AND ACCIDENT | $49K | — | $49K | 15.00% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 38 FOUNTAIN SQUARE PLAZA MD1090GB CINCINNATI, OH 45202 | TOKIO MARINE HCC | $19K | — | $19K | 6.54% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 8335 KEYSTONE XING STE 106 INDIANAPOLIS, IN 46240 | DELTA DENTAL OF KENTUCKY | $3K | — | $3K | 2.43% |
| INTEGRO INSURANCE BROKERS3 Filed as: EPIC INSURANCE SOLUTIONS LLC | 9700 ORMSBY STATION ROAD SUITE 200 LOUISVILLE, KY 40223 | CITIZENS SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 38 FOUNTAIN SQUARE PLAZA CINCINNATI, OH 45202 | TELEDOC | $3K | — | $3K | 16.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| URM,INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $93K |
| ANTHEM HEALTH PLANS OF KENTUCKY EIN 61-1237516 ADMIN | Contract Administrator; Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $16K |
| FIFTH THIRD INSURANCE AGENCY INC BROKER | Other commissions Service code 55 | 38 FOUNTAIN SQUARE PLAZA MD1090GB CINCINNATI, OH 45202 | $7K |
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 | 631 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 631 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 810 | $131K |
| Vision | CITIZENS SECURITY LIFE INSURANCE COMPANY | 432 | $46K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 631 | $327K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 631 | $327K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 520 | $285K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 631 | $345K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 810 | — |
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.