| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUGH G HINES3 | 121 E MAIN STREET DANVILLE, KY 40422 | NORTHWESTERN MUTUAL | $5K | $1K | $6K | 0.61% |
| PROCTOR W BLAIR3 | 416 HIGH STREET PARIS, KY 40361 | NORTHWESTERN MUTUAL | $4K | $908 | $5K | 0.44% |
| JOHN W. ROSS3 | 214 E CENTER STREET KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $3K | $726 | $4K | 0.35% |
| MICHAEL TROUT3 Filed as: MICHAEL EDWARD CULLIGAN | 214 E CENTER STREET KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $3K | $726 | $4K | 0.35% |
| NM LOUISVILLE INC3 Filed as: NM LOUISVILLE, INC. | 462 S 4TH STREET, SUITE 1900 LOUISVILLE, KY 40202 | NORTHWESTERN MUTUAL | $1K | $147 | $1K | 0.13% |
| CHARLES NATHANIEL JENKINS3 | 208 SUNSET DRIVE, SUITE 401 JOHNSON CITY, TN 37604 | NORTHWESTERN MUTUAL | $576 | $207 | $783 | 0.08% |
| ADAM KEITH ELLIS3 | STE 114B 1945 SCOTTSVILLE ROAD BOWLING GREEN, KY 42104 | NORTHWESTERN MUTUAL | $504 | $181 | $685 | 0.07% |
| CHARLES ROBERT PRUETT3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $576 | $69 | $645 | 0.06% |
| MCGRIFF INSURANCE SERVICES INC3 | — | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $8K | — | $8K | 0.85% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SERVICES - LOUISVILLE | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | $48K | $4K | $52K | 11.80% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | ROBIN DAVIS 3201 BEECHLEAF COURT GREENSBORO, NC 27604 | DELTA DENTAL OF KENTUCKY | $9K | — | $9K | 2.29% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 282171964 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19K | — | $19K | 13.46% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3605 GLENWOOD AVENUE RALEIGH, NC 27612 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 15.00% |
| AIS - BENEFIT CONCEPTS LLC3 | 13101 MAGISTERIAL DR LOUISVILLE, KY 40223 | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | $246 | — | $246 | 2.10% |
| AIS - BENEFIT CONCEPTS LLC3 | 13101 MAGISTERIAL DR LOUISVILLE, KY 40223 | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | $77 | — | $77 | 1.55% |
| 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 | $341 | — | $341 | 10.15% |
| 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 |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 BROKER | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | — | $1.2M |
| MCGRIFF INSURANCE SERVICES, INC | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions; Non-monetary compensation Service code 22 | — | $45K |
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 | 913 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 944 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | 6 | $17K |
| Dental | DELTA DENTAL OF KENTUCKY | 1,403 | $395K |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 1,618 | $915K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 911 | $440K |
| Long-term disability(5 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 908 | $1.0M |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 1,618 | $915K |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 911 | $688K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,618 | — |
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."
No prospect flags tripped on this filing.