| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R H CLARKSON FINANCIAL SERVICES INC3 Filed as: R H CLARKSON FINANCIAL SERVICES | PO BOX 70529 LOUISVILLE, KY 40270 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $132K | — | $132K | 1.63% |
| R H CLARKSON FINANCIAL SERVICES INC3 Filed as: R H CLARKSON FINANCIAL SERVICES | PO BOX 70529 LOUISVILLE, KY 40270 | HUMANA INSURANCE COMPANY | $26K | — | $26K | 3.32% |
| ROBERT H CLARKSON INSURANCE3 | 401 W MAIN ST, STE 1500 LOUISVILLE, KY 40202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 3.18% |
| R H CLARKSON FINANCIAL SERVICES INC3 Filed as: R H CLARKSON FINANCIAL SERVICES | PO BOX 70529 LOUISVILLE, KY 40270 | HUMANA HEALTH PLAN, INC | $300 | — | $300 | 0.57% |
| R H CLARKSON FINANCIAL SERVICES INC3 Filed as: R H CLARKSON FINANCIAL SERVICES | PO BOX 70529 LOUISVILLE, KY 40270 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 4.05% |
| R H CLARKSON FINANCIAL SERVICES INC3 Filed as: R H CLARKSON FINANCIAL SERVICES | PO BOX 70529 LOUISVILLE, KY 40270 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $600 | — | $600 | 2.47% |
| ROBERT H CLARKSON INSURANCE3 | 401 W MAIN ST, STE 1500 LOUISVILLE, KY 40202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| R H CLARKSON FINANCIAL SERVICES INC3 Filed as: R H CLARKSON FINANCIAL SERVICES | PO BOX 70529 LOUISVILLE, KY 40270 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $150 | — | $150 | 2.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator; Other services Service code 13 | — | $412K |
| ANTHEM EIN 61-1237516 NONE | Contract Administrator; Other insurance fees and expenses Service code 13 | — | $266K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $127K |
| JOHNSON & KROL LLC EIN 36-4342024 NONE | Legal; Direct payment from the plan Service code 29 | — | $124K |
| COMMONWEALTH BANK AND TRUST NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 4350 BROWNSBORO ROAD, SUITE 210 LOUISVILLE, KY 40207 | $56K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $53K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Contract Administrator; Other insurance fees and expenses Service code 13 | — | $24K |
| STRATEGIC CAPITAL INVESTMENT ADVISO EIN 36-4268991 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $16K |
| AMERICAN GRAPHICS PRINTING COMPANY NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 34895 GROESBECK HWY CLINTON, MI 48035 | $11K |
| DUNN & WALLBAUM PLLC EIN 46-1576504 NONE | Legal; Direct payment from the plan Service code 29 | — | $7K |
| PNC BANK NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | P.O. BOX 609 PITTSBURGH, PA 15230 | $7K |
| SEGAL ROGERSCASEY EIN 13-2646110 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $5K |
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 | 1,203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 518 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,721 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 466 | $9.0M |
| Dental | DELTA DENTAL OF KENTUCKY | 4,192 | $1.1M |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 3,935 | $31K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,644 | $184K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,204 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,192 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.