| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIFTH THIRD INSURANCE AGENCY INC3 | 9700 ORMSBY STATION ROAD STE 200 LOUISVILLE, KY 40223 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | — | $211 | $211 | 0.04% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 8335 KEYSTONE XING STE 106 INDIANAPOLIS, IN 46240 | DELTA DENTAL OF KENTUCKY | $2K | — | $2K | 0.97% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 38 FOUNTAIN SQUARE PLAZA CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| MCCONNELL INSURANCE AGENCY SERVICES3 | ATTN JOHN MCCONNELL MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.44% |
| EMPLOYEE BENEFIT SOLUTIONS INC3 Filed as: EMPLOYEE BENEFIT SOLUTIONS LLC | 2785 MAYFIELD HIGHWAY BENTON, KY 42025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $89 | $1K | 2.36% |
| ANDREW THOMAS DONOHOO3 | 2250 HAL DR MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $819 | $13 | $832 | 1.57% |
| KING INSURANCE AGENCY3 Filed as: KING INSURANCE SERVICES INC | 703 JEFFERSON STREET PADUCAH, KY 42001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $588 | — | $588 | 1.11% |
| ANGELA K ROWLETT LAMPE3 | 4384 VAN CLEAVE ROAD MURRAY, KY 42071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $258 | — | $258 | 0.49% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 0.31% |
| DEBORAH S GOLDEN3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | — | $117 | 0.22% |
| HOLLANDSTIVERS EMPLOYER SOLUTIONS L3 | 2660 OLIVET CHURCH RD PADUCAH, KY 42001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 0.21% |
| HOLLAND STIVERS EMPLOYER SOLUTIONS3 Filed as: HOLLAND STIVERS & ASSOCIATES LLC | 2660 OLIVET CHURCH ROAD PADUCAH, KY 42001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.10% |
| SUSAN MAE DANIEL3 | 2713 CAYCE MEADE DRIVE HOPKINSVILLE, KY 42240 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.09% |
| FRANKIE GLEE WILLIAMS3 | 206 HURRICANE SHORES RD SCOTTSVILLE, KY 42164 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.06% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 38 FOUNTAIN SQUARE PLAZA CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| FIFTH THIRD INSURANCE AGENCY INC3 | 38 FOUNTAIN SQUARE PLAZA CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| FIFTH THIRD INSURANCE AGENCY INC3 | — | TELEDOC | $3K | — | $3K | 14.99% |
| MCCONNELL INSURANCE AGENCY SERVICES3 Filed as: MCCONNELL INS AGENCY SRVCS INC | PO BOX 795 MURRAY, KY 42071 | COMPANION LIFE INSURANCE COMPANY | $881 | — | $881 | 16.99% |
| PLANCHOICE INC3 | 13257 O'BANNON STATION WAY LOUISVILLE, KY 40223 | COMPANION LIFE INSURANCE COMPANY | $482 | — | $482 | 9.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 ADMIN/NETWORK PHARMACY | Float revenue; Other services; Claims processing; Contract Administrator; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $374K |
| FIFTH THIRD INSURANCE AGENCY INC | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $37K |
| EPIC INSURANCE SOLUTIONS LLC | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | — | $26K |
| INGENIORX, INC. EIN 82-3062245 ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Contract Administrator Service code 12 | — | -$103K |
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 | 353 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 690 | $168K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 353 | $98K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 75 | $53K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $46K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 619 | $501K |
| Other(6 contracts, 5 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 359 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 690 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.