| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY, INC. | 1240 FAIRWAY STREET BOWLING GREEN, KY 42103 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $3K | — | $3K | 9.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $222K |
| USI MIDWEST, INC. EIN 31-0507943 BROKER | Other commissions Service code 55 | — | $89K |
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 | 148 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 451 | $29K |
| Stop-loss / reinsurancereinsurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 280 | $585K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.