| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND INC. | PO BOX 427 BENTON, KY 42025 | ANTHEM LIFE INSURANCE COMPANY | $7K | $0 | $7K | 11.74% |
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND INC. | 1120 MAIN STREET BENTON, KY 42025 | DELTA DENTAL OF KENTUCKY | $1K | $0 | $1K | 8.97% |
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND INC. | PO BOX 8167 PADUCAH, KY 42002 | VISION SERVICE PLAN | $728 | $0 | $728 | 7.14% |
| KIM DIANE JONES3 | 533 BELLWOOD ROAD LEBANON, TN 37087 | AFLAC | $468 | $0 | $468 | 4.73% |
| KENNETH R APPLE3 Filed as: KENNETH R. APPLE | 830 WILLOW TREE CIRCLE COROVA, TN 38018 | AFLAC | $230 | $0 | $230 | 2.32% |
| ALAN W MARTIN3 Filed as: ALAN W. MARTIN | 12524 MALARD BAY DRIVE KNOXVILLE, TN 37922 | AFLAC | $115 | $0 | $115 | 1.16% |
| MJ INSURANCE3 Filed as: ANGELA K. DOWDY AND VARIOUS AGENTS | 18837 CANOEBROOK LANE TONEU, AL 35773 | AFLAC | $77 | $0 | $77 | 0.78% |
| ROBERT L GOBLE3 Filed as: ROBERT L. GOBLE | 250 34TH AVENUE NE HICKORY, NC 28601 | AFLAC | $69 | $0 | $69 | 0.70% |
| AMANDA M ROBERTS3 Filed as: AMANDA M. ROBERTS | 1080 STATE ROUTE 1907 FULTON, KY 42041 | AFLAC | $30 | $0 | $30 | 0.30% |
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND INC. | PO BOX 427 BENTON, KY 42025 | AFLAC | $27 | $0 | $27 | 0.27% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 55 | $15K |
| Vision | VISION SERVICE PLAN | 64 | $10K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 110 | $57K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 110 | $57K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 110 | $57K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 110 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.