| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUGH G HINES3 | 121 E MAIN STREET DANVILLE, KY 40422 | NORTHWESTERN MUTUAL | $5K | $1K | $7K | 0.66% |
| PROCTOR W BLAIR3 | 416 HIGH STREET PARIS, KY 40361 | NORTHWESTERN MUTUAL | $4K | $933 | $5K | 0.46% |
| JOHN W. ROSS3 | 214 E CENTER STREET KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $3K | $747 | $4K | 0.37% |
| MICHAEL TROUT3 Filed as: MICHAEL EDWARD CULLIGAN | 214 E CENTER STREET KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $3K | $747 | $4K | 0.37% |
| NM LOUISVILLE INC3 Filed as: NM LOUISVILLE, INC. | 462 S 4TH STREET, SUITE 1900 LOUISVILLE, KY 40202 | NORTHWESTERN MUTUAL | $1K | $175 | $2K | 0.16% |
| CHARLES NATHANIEL JENKINS3 | 208 SUNSET DRIVE, SUITE 401 JOHNSON CITY, TN 37604 | NORTHWESTERN MUTUAL | $592 | $213 | $805 | 0.08% |
| CHARLES ROBERT PRUETT3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $592 | $71 | $663 | 0.07% |
| ADAM KEITH ELLIS3 | STE 114B 1945 SCOTTSVILLE ROAD BOWLING GREEN, KY 42104 | NORTHWESTERN MUTUAL | $316 | $113 | $429 | 0.04% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | COMMISSION PROCESSING UNIT GREENSBORO, NC 27409 | DELTA DENTAL OF KENTUCKY | $25K | — | $25K | 7.43% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS. SERVICES - LOUISVILLE | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $5K | $31K | 10.98% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SERVICES - LOUISVILLE | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $4K | $24K | 10.99% |
| MCGRIFF INSURANCE SERVICES INC3 | 3605 GLENWOOD AVE, SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18K | — | $18K | 12.43% |
| BB&T INS SER INC-LOUISVILLE3 | PO BOX 436869 LOUISVILLE, KY 402536869 | THE DENTAL CONCERN, INC. | $9K | $4K | $13K | 14.12% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB & T INSURANCE SERVICES | 3605 GLENWOOD AVENUE RALEIGH, NC 27612 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 15.00% |
| AIS - BENEFIT CONCEPTS LLC3 | 13101 MAGISTERIAL DR LOUISVILLE, KY 40223 | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | $367 | — | $367 | 2.15% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS. SERVICES, LOUISVILLE | ATTN BONNIE EDWARDS 414 GALLIMORE DAIRY RD, STE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $532 | — | $532 | 10.01% |
| AIS - BENEFIT CONCEPTS LLC3 | 13101 MAGISTERIAL DR LOUISVILLE, KY 40223 | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | $77 | — | $77 | 1.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF KY INC | 13101 MAGISTERIAL DR STE 200 LOUISVILLE, KY 40223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $123 | — | $123 | 17.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $618K |
| BB&T INSURANCE SERVICES EIN 56-1623293 BROKER | Other commissions Service code 55 | — | $154K |
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 BROKER | Other fees; Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $120K |
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 | 931 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 954 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | 8 | $22K |
| Dental | DELTA DENTAL OF KENTUCKY | 1,302 | $340K |
| Vision | THE DENTAL CONCERN, INC. | 534 | $89K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 929 | $495K |
| Long-term disability(5 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 924 | $1.0M |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 1,573 | $915K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,582 | $1.1M |
| Other(6 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 929 | $730K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,582 | — |
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.