| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 2975 REGENT BLVD. IRVING, TX 75063 | DELTA DENTAL OF KENTUCKY | $2K | — | $2K | 4.19% |
| VICKI R. WILLIAMS3 Filed as: VICKI R WILLIAMS | 111 N EWING AVE LOUISVILLE, KY 40206 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $500 | — | $500 | 2.53% |
| VANCE NEAL MICHAEL3 | 1005 RICHMOND RD LEXINGTON, KY 40502 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $291 | $77 | $368 | 1.86% |
| MARY DUFF3 | 1005 RICHMOND RD LEXINGTON, KY 40502 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $23 | $57 | 0.29% |
| RALPH E MYERS3 | 13117 EASTPOINT PARK BLVD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.24% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.21% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES M BENNETT | PO BOX 573 FRANKFORT, KY 40602 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.19% |
| DEBORAH S GOLDEN3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.15% |
| BRIAN K TAYLOR3 | 1400 NORTHWIND RD LOUISVILLE, KY 40207 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.14% |
| MICHAEL J BOONE3 | 1302 CLEAR SPRINGS TRACE LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.11% |
| VICKIE E LEWIS3 | 6558 STOVALL RD CAVE CITY, KY 42127 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.06% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| COURTLANN M ATKINSON3 | 618 FAIRWAY ST BOWLING GREEN, KY 42103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 720E PETE ROSE WAY #400 CINCINNATI, OH 45202 | EYEMED VISION CARE | $1K | — | $1K | 9.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY EIN 61-1237516 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services; Other fees Service code 12 | — | $149K |
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 | 136 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 251 | $225K |
| Dental | DELTA DENTAL OF KENTUCKY | 278 | $57K |
| Vision | EYEMED VISION CARE | 226 | $15K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 65 | $15K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 34 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.