| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEVEN CORNERS INSURANCE SOLUTIONS3 Filed as: SEVEN CORNERS INSURANCE | 21241 S WESTERN AVE SUITE 250 TORRANCE, CA 90501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| BENEFIT INSURANCE MARKETING, INC.3 Filed as: BENEFIT INSURANCE MARKETING | 1151 RED MILE RD LEXINGTON, KY 40504 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 3.04% |
| SEVEN CORNERS INSURANCE SOLUTIONS3 Filed as: SEVEN CORNERS INSURANCE | 21241 S WESTERN AVE SUITE 250 TORRANCE, CA 90501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.19% |
| BENEFIT INSURANCE MARKETING, INC.3 Filed as: BENEFIT INSURANCE MARKETING | 1151 RED MILE RD LEXINGTON, KY 40504 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $773 | $773 | 2.92% |
| SEVEN CORNERS INSURANCE SOLUTIONS3 Filed as: SEVEN CORNERS INSURANCE | 21241 S WESTERN AVE SUITE 250 TORRANCE, CA 90501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| BENEFIT INSURANCE MARKETING, INC.3 Filed as: BENEFIT INSURANCE MARKETING | 1151 RED MILE RD LEXINGTON, KY 40504 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $710 | $710 | 3.34% |
| SEVEN CORNERS INSURANCE SOLUTIONS3 Filed as: SEVEN CORNERS INSURANCE | 21241 S WESTERN AVE SUITE 250 TORRANCE, CA 90501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $519 | — | $519 | 10.00% |
| AP WHOLESALE INSURANCE SERVICES LLC3 | 2001 LAKE POINT WAY LOUISVILLE, KY 40223 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $1K | $0 | $1K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY,INC EIN 61-1237516 CLAIM ADMINISTRATION | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | — | $117K |
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 CLAIM ADMINISTRATION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $94K |
| AP WHOLESALE INSURANCE SERVICES LLC | Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $33K |
| AP WHOLESALE INSURANCE SERVICE LLC SERVICE PROVIDER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions; Non-monetary compensation Service code 22 | 2001 LAKE POINT WAY LOUISVILLE, KY 40223 | $0 |
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 | 106 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 106 | $0 |
| Dental | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 106 | $0 |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 106 | $0 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 106 | $44K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 75 | $21K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $26K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 106 | $0 |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 106 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.