| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLLAND STIVERS EMPLOYER SOLUTIONS3 | LLC 2660 OLIVET CHURCH ROAD, SUITE 1 PADUCAH, KY 42001 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $26K | — | $26K | 2.80% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $267 | $2K | 2.76% |
| HOLLANDSTIVERS EMPLOYER SOLUTIONS3 | LLC 2660 OLIVET CHURCH ROAD, SUITE 1 PADUCAH, KY 42001 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.72% |
| HOUCHENS INSURANCE GROUP INC3 | 1240 FAIRWAY STREET BOWLING GREEN, KY 42103 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $880 | — | $880 | 1.37% |
| DEBORAH S GOLDEN3 | 1830 DESTINY LANE BOWLING GREEN, KS 42104 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $784 | $86 | $870 | 1.36% |
| JODY DAN BRYANT3 | 1429 MOUNT AYR CIRCLE BOWLING GREEN, KY 42103 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $432 | — | $432 | 0.67% |
| FRANKIE GLEE WILLIAMS3 | 206 HURRICANE SHORES ROAD SCOTTSVILLE, KY 42164 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $367 | — | $367 | 0.57% |
| SUSAN MAE DANIEL3 | 2713 CAYCE MEADE DRIVE HOPKINSVILLE, KY 42240 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $283 | — | $283 | 0.44% |
| VIOLET P COOTS3 | 1410 WHALEN ROAD BOWLING GREEN, KY 42101 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $194 | $2 | $196 | 0.31% |
| FRANK ANTHONY LAIRD3 | 4365 WOODLAND HILL DRIVE KEVIL, KS 42053 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.14% |
| DAVID SPARKS PURVIS3 | 3840 SADDLE BEND DRIVE OLIVE BRANCH, MS 38654 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 0.13% |
| JEFFREY WANN3 | 513 E EAGLE PASS ROAD ELIZABETHTOWN, KY 42701 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.04% |
| MARYANNE ANDERSON3 | 1014 EDGEFIELD WAY BOWLING GREEN, KY 42104 | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.03% |
| HOLLANDSTIVERS EMPLOYER SOLUTIONS3 | LLC 2660 OLIVET CHURCH ROAD SUITE 1 PADUCAH, KY 42001 | AMERICAN UNITED LIFE INSURANCE COMPANY | $7K | $2K | $9K | 18.28% |
| HOLLANDSTIVERS EMPLOYER SOLUTIONS3 | LLC JODY STIVERS 2660 OLIVET CHURCH ROAD, SUITE 1 PADUCAH, KY 42001 | DELTA DENTAL OF KENTUCKY | $2K | — | $2K | 7.55% |
| HOLLANDSTIVERS EMPLOYER SOLUTIONS3 | LLC JODY STIVERS 2660 OLIVET CHURCH ROAD, SUITE 1 PADUCAH, KY 42001 | DELTA DENTAL OF KENTUCKY | $879 | — | $879 | 7.54% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 156 | $911K |
| Dental | DELTA DENTAL OF KENTUCKY | 140 | $32K |
| Vision | DELTA DENTAL OF KENTUCKY | 159 | $12K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 180 | $51K |
| Other(2 contracts, 2 carriers) | CCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 180 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.