| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUGH G HINES3 | 121 E MAIN STREET DANVILLE, KY 40422 | NORTHWESTERN MUTUAL | $5K | $1K | $7K | 0.63% |
| PROCTOR W BLAIR3 | 416 HIGH STREET PARIS, KY 40361 | NORTHWESTERN MUTUAL | $4K | $988 | $5K | 0.45% |
| JOHN W. ROSS3 | 214 E CENTER STREET KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $3K | $791 | $4K | 0.36% |
| MICHAEL TROUT3 Filed as: MICHAEL EDWARD CULLIGAN | 214 E CENTER STREET KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $3K | $791 | $4K | 0.36% |
| NM LOUISVILLE INC3 Filed as: NM LOUISVILLE, INC. | 462 S 4TH STREET, SUITE 1900 LOUISVILLE, KY 40202 | NORTHWESTERN MUTUAL | $1K | $160 | $1K | 0.14% |
| CHARLES NATHANIEL JENKINS3 | 208 SUNSET DRIVE, SUITE 401 JOHNSON CITY, TN 37604 | NORTHWESTERN MUTUAL | $627 | $225 | $852 | 0.08% |
| ADAM KEITH ELLIS3 | STE 114B 1945 SCOTTSVILLE ROAD BOWLING GREEN, KY 42104 | NORTHWESTERN MUTUAL | $549 | $197 | $746 | 0.07% |
| CHARLES ROBERT PRUETT3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $627 | $75 | $702 | 0.06% |
| MCGRIFF INSURANCE SERVICES INC3 | — | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $9K | $4K | $12K | 1.37% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SERVICES - LOUISVILLE | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | $56K | $4K | $60K | 10.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | ROBIN DAVIS 3201 BEECHLEAF COURT GREENSBORO, NC 27604 | DELTA DENTAL OF KENTUCKY | $10K | — | $10K | 2.50% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3605 GLENWOOD AVENUE RALEIGH, NC 27612 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | EB COMMISSION PO BOX 89662 CHARLOTTE, NC 282896620 | UNUM INSURANCE COMPANY | $13K | $2K | $15K | 17.00% |
| AIS - BENEFIT CONCEPTS LLC3 | 13101 MAGISTERIAL DR LOUISVILLE, KY 40223 | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | $77 | — | $77 | 1.55% |
| AIS - BENEFIT CONCEPTS LLC3 | 13101 MAGISTERIAL DR LOUISVILLE, KY 40223 | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | $170 | — | $170 | 5.00% |
| 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 | $225 | — | $225 | 9.98% |
| 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 | Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $1.2M |
| MCGRIFF INSURANCE SERVICES, INC | Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $36K |
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 | 954 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 979 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | MANHATTAN LIFE ASSURANCE COMPANY OF AMERICA | 5 | $8K |
| Dental | DELTA DENTAL OF KENTUCKY | 1,390 | $395K |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 726 | $911K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 954 | $561K |
| Long-term disability(5 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 939 | $1.1M |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 726 | $911K |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 954 | $750K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,390 | — |
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.