| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2325 GREEN VALLEY ROAD NEW ALBANY, IN 47150 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $291 | $11K | 10.88% |
| MJ INSURANCE3 Filed as: MARSHA CLARKSON AND VARIOUS AGENTS | 6311 FAIRPLAY ROAD COLUMBIA, KY 42728 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $171 | $3K | 2.67% |
| WILLIAM JACK MITCHELL JR3 Filed as: WILLIAM JACK MITCHELL, JR. | 2906 VALLEY DRIVE JEFFERSONTOWN, KY 40299 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $395 | $2K | 1.95% |
| JEFFREY D HARNED3 Filed as: JEFFREY D. HARNED | 13117 EASTPOINT PARK BOULEVARD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $507 | $2K | 1.91% |
| COURTLANN M ATKINSON3 Filed as: COURTLANN M. ATKINSON | 618 FAIRWAY STREET BOWLING GREEN, KY 42103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.60% |
| LEIGH L ARMSTRONG3 Filed as: LEIGH L. ARMSTRONG | 1330 WALNUT WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $127 | $1K | 1.28% |
| AXEL H HALVARSON3 Filed as: AXEL H. HALVARSON | 13117 EASPOINT PARK BOULEVARD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $32 | $1K | 1.09% |
| ASSURED NEACE LUKENS INS. AGENCY3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $6K | $21K | 21.74% |
| ASSURED NEACE LUKENS INS. AGENCY3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | DELTA DENTAL OF KENTUCKY | $5K | — | $5K | 7.46% |
| ASSURED NEACE LUKENS INS. AGENCY3 | 1945 SCOTTSVILLE ROAD, SUITE 100 BOWLING GREEN, KY 42104 | COMPBENEFITS INSURANCE COMPANY | $2K | — | $2K | 10.54% |
| ASSURED NEACE LUKENS INS. AGENCY3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | COMPBENEFITS INSURANCE COMPANY | $942 | — | $942 | 5.47% |
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 | 135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 319 | $72K |
| Vision | COMPBENEFITS INSURANCE COMPANY | 132 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $95K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $95K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $95K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 151 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.