| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCONNELL INSURANCE AGENCY SERVICES3 | ATTN JOHN MCCONNELL MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $408 | $7K | 7.50% |
| ANGELA K ROWLETT LAMPE3 | 4384 VAN CLEAVE RD MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $66 | $5K | 5.19% |
| KING INSURANCE AGENCY3 Filed as: KING INSURANCE SERVICES, INC. | 703 JEFFERSON ST PADUCAH, KY 42001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.87% |
| EMPLOYEE BENEFIT SOLUTIONS INC3 Filed as: EMPLOYEE BENEFIT SOLUTIONS LLC | 2785 MAYFIELD HWY BENTON, KY 42025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $330 | $1K | 1.51% |
| ANDREW THOMAS DONOHOO3 | 515 SHADY LN MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $703 | $25 | $728 | 0.75% |
| LESLIE ANN FEATHERLY3 | 134 SUNNINGDALE DRIVE GEORGETOWN, KY 40324 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $387 | $33 | $420 | 0.43% |
| AMY BOWMAN3 | 6214 SULPHUR WELL NICHOLASVILLE, KY 40356 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $250 | $136 | $386 | 0.40% |
| BEVERLY J REED3 Filed as: BEVERLY J. REED | 163 HARRISON RD BENTON, KY 42025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $348 | — | $348 | 0.36% |
| TYLER WOLFE3 | 518 SOUTH 12TH STREET MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $232 | $109 | $341 | 0.35% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $294 | — | $294 | 0.30% |
| HOLLAND STIVERS EMPLOYER SOLUTIONS3 Filed as: HOLLAND STIVERS & ASSOCIATES LLC | 2660 OLIVET CHURCH RD PADUCAH, KY 42001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $281 | — | $281 | 0.29% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH S. GOLDEN | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $200 | — | $200 | 0.21% |
| SUSAN MAE DANIEL3 | 363 PLEASANT PLACE WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $81 | — | $81 | 0.08% |
| FRANKIE GLEE WILLIAMS3 | 725 STEEPLECHASE WAY BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.07% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON RD MISHAWAKA, IN 46544 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.02% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2416 SIR BARTON WAY #300 LOUISVILLE, KY 40509 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| LISA R GRAVES3 Filed as: LISA F. CASSADY-LEE | 260 SUGAR MILL DRIVE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| MICHAEL J BOONE3 Filed as: MICHAEL J. BOONE | 1302 CLEAR SPRINGS TRACE LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| MARSHA CLARKSON3 | 328 BARREN MEADOWS DRIVE GLASGO, KY 42141 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| COURTLANN M ATKINSON3 Filed as: COURTLANN M. ATKINSON | 618 FAIRWAY ST. BOWLING GREEN, KY 42103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| VICKIE E LEWIS3 Filed as: VICKIE E. LEWIS | 6558 STOVAL RD CAVE CITY, KY 42127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| BARBARA J LAKE3 | 226 N HIGH ST MORRISTOWN, IN 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| DENNIS W BYERS3 | 8739 PROMONTORY RD INDIANAPOLIS, IN 46236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| MCCONNELL INSURANCE AGENCY SERVICES3 | PO BOX 795 MURRAY, KY 42071 | COMPANION LIFE | $4K | $10 | $4K | 15.04% |
| PLANCHOICE INC3 | 13257 O'BANNON STATION WAY LOUISVILLE, KY 40223 | COMPANION LIFE | $2K | — | $2K | 7.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 INSURANCE COMPANY | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $54K |
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 | 383 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 144 | $122K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 144 | $97K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 144 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.