| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | ANTHEM HEALTH PLANS OF KY, INC. | $22K | $0 | $22K | 1.80% |
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND, INC. | PO BOX 427 BENTON, KY 42025 | ANTHEM HEALTH PLANS OF KY, INC. | $2K | $0 | $2K | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | DBA HUB INTERNATIONAL MID-SO BENTON, KY 42025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $1K | $9K | 16.09% |
| TED BENNETT3 | 1087 ARISTIDES DRIVE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $238 | $3K | 5.05% |
| JEFFREY WANN3 Filed as: JEFFREY WANN & OTHER AGENTS | 513 EAST EAGLE PASS ROAD ELIZABETHTOWN, KY 42701 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $142 | $2K | 3.78% |
| DEBORAH S GOLDEN3 | 1505 AQUARIUS WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $323 | $2K | 2.71% |
| DAVID SPARKS PURVIS3 | 3840 SADDLE BEND OLIVE BRANCH, MS 38654 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $307 | $1K | 2.63% |
| KRISTIN BENNETT3 | 1462 HAMILTON COURT BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.91% |
| MARYANNE ANDERSON3 | 1014 EDGEFIELD WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $931 | $24 | $955 | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 392 TRAVERSE CITY, MI 49685 | DELTA DENTAL OF KENTUCKY | $3K | $0 | $3K | 7.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | DBA HUB INTERNATIONAL MID-SO BENTON, KY 42025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $385 | $3K | 9.63% |
| TED BENNETT3 | 1087 ARISTIDES DRIVE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $62 | $1K | 3.69% |
| FRANKIE GLEE WILLIAMS3 Filed as: FRANKIE G. WILLIAMS & OTHER AGENTS | 186 CHAMBERS DRIVE BOWLING GREEN, KY 42103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $953 | $79 | $1K | 3.56% |
| DEBORAH S GOLDEN3 | 1505 AQUARIUS WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $453 | $84 | $537 | 1.85% |
| KRISTIN BENNETT3 | 1462 HAMILTON COURT BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $419 | — | $419 | 1.44% |
| MARYANNE ANDERSON3 | 1014 EDGEFIELD WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $252 | $6 | $258 | 0.89% |
| THERESA DIANE NETHERTON3 | 3368 DOVER CHURCH ROAD GLASGOW, KY 42141 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $178 | $16 | $194 | 0.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 1120 MAIN STREET BENTON, KY 42025 | AMERICAN UNITED LIFE INSURANCE COMPANY | $4K | $476 | $5K | 16.66% |
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND, INC. | PO BOX 427 BENTON, KY 42025 | AMERICAN UNITED LIFE INSURANCE COMPANY | $6 | $590 | $596 | 2.11% |
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 | 196 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KY, INC. | 102 | $1.2M |
| Dental | DELTA DENTAL OF KENTUCKY | 124 | $40K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 0 | $0 |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 205 | $28K |
| Prescription drug | ANTHEM HEALTH PLANS OF KY, INC. | 102 | $1.2M |
| Other(4 contracts, 3 carriers) | ANTHEM HEALTH PLANS OF KY, INC. | 205 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.