| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 | 2125 YGNACIO VALLEY RD, STE 200 WALNUT CREEK, CA 94598 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $33K | $2K | $36K | 3.46% |
| FOUNDATION RISK PARTNERS CORP3 | 2125 YGNACIO VALLEY RD, STE 200 WALNUT CREEK, CA 94598 | STANDARD INSURANCE COMPANY | $13K | $1K | $14K | 16.01% |
| FOUNDATION RISK PARTNERS CORP3 | 38 FOUNTAIN SQUARE PLAZA CINCINNATI, OH 45202 | AFLAC | $2K | — | $2K | 6.36% |
| REBECCA A MCLAUGHLAN3 Filed as: REBECCA DOEPKE | 4019 DEER LAKE CIRCLE PROSPECT, KY 40059 | AFLAC | $753 | — | $753 | 2.60% |
| AMBER NICOLE RICHARDSON3 Filed as: AMBER RICHARDSON | 1241 LYNDON LANE RADCLIFF, KY 40160 | AFLAC | $602 | $62 | $664 | 2.29% |
| ERIN SMITH3 | 112 EARLY TIMES BLVD BARDSTOWN, KY 40004 | AFLAC | $458 | — | $458 | 1.58% |
| MARK GALVIN LLC3 | 204 DEERFIELD HILLS ROAD ELIZABETHTOWN, KY 42701 | AFLAC | $297 | — | $297 | 1.03% |
| KIRK HASTINGS3 | 8707 CHETWOOD TRACE DRIVE LOUISVILLE, KY 40291 | AFLAC | $190 | — | $190 | 0.66% |
| AMY JOHANNEMANN3 | 11708 W. STATE ROAD 56 FRENCH LICK, IN 47432 | AFLAC | $121 | — | $121 | 0.42% |
| BRIAN GRAHAM INC3 Filed as: BRIAN GRAHAM | 903 TAMARISK CT LOUISVILLE, KY 40223 | AFLAC | $118 | — | $118 | 0.41% |
| PAMELA ROWSEY LARSON3 Filed as: PAMELA LARSON | 844 SANDSTONE RD COLD SPRING, KY 41076 | AFLAC | $114 | — | $114 | 0.39% |
| SETH O AKERS3 Filed as: SETH AKERS | 487 NORMANDY STATION ROAD TAYLORSVILLE, KY 40071 | AFLAC | $90 | $8 | $98 | 0.34% |
| BRIAN GRAHAM INC3 Filed as: BRIAN GRAHAM | 2201 POLO MOUNT CT LOUISVILLE, KY 40245 | AFLAC | $61 | — | $61 | 0.21% |
| DAVID WATSON3 | 3912 FALLEN TIMBER DRIVE LOUISVILLE, KY 40241 | AFLAC | $51 | — | $51 | 0.18% |
| TIFFANY ANN AKERS3 Filed as: TIFFANY AKERS | 487 NORMANDY STATION ROAD TAYLORSVILLE, KY 40071 | AFLAC | $34 | — | $34 | 0.12% |
| BRYAN ALARCON3 | 205 MACINTOSH DRIVE SHELBYVILLE, KY 40065 | AFLAC | $31 | — | $31 | 0.11% |
| DAVID LUURTSEMA3 | 326 OLD CARDINAL DRIVE ELIZABETHTOWN, KY 42701 | AFLAC | $28 | — | $28 | 0.10% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL LLC | 5905 E. GALBRAITH RD, STE 5000 CINCINNATI, OH 45236 | AFLAC | $26 | — | $26 | 0.09% |
| DAVID HUGHES3 | 2806 SATSUMA DR SARASOTA, FL 34239 | AFLAC | $20 | — | $20 | 0.07% |
| BRADLEY L ELLIS3 Filed as: BRADLEY ELLIS | 6807 GRAINERY RD TIMNATH, CO 80547 | AFLAC | $18 | — | $18 | 0.06% |
| PHILLIP D BLAKEMAN3 Filed as: PHILLIP BLAKEMAN | 217 REMBRANDT DRIVE ELIZABETHTOWN, KY 42701 | AFLAC | $13 | — | $13 | 0.04% |
| R AARON WRIGHT3 | 9505 TRUSCOTT CT LOUISVILLE, KY 40059 | AFLAC | $11 | — | $11 | 0.04% |
| LAURA MARIE GOVANUS3 Filed as: LAURA LEKSRISAWAT | 5734 N. STATE ROAD 66 MILLTOWN, IN 47145 | AFLAC | $5 | — | $5 | 0.02% |
| DENNIS HARTIN3 | 12203 STATE STREET TAMPA, FL 33635 | AFLAC | $2 | — | $2 | 0.01% |
| CLIFFORD FRANKLIN BROOKS3 Filed as: CLIFFORD BROOKS | 9200 SHELBYVILLE RD STE 605 LOUISVILLE, KY 40222 | AFLAC | $2 | — | $2 | 0.01% |
| FOUNDATION RISK PARTNERS CORP3 | 2125 YGNACIO VALLEY RD, STE 200 WALNUT CREEK, CA 94598 | ANTHEM LIFE INSURANCE COMPANY | $189 | — | $189 | 1.25% |
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 | 163 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 188 | $1.0M |
| Dental | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 188 | $1.0M |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 188 | $1.0M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 167 | $102K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 167 | $102K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 167 | $102K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 167 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.