| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 3430 CARMEL, IN 46082 | UNITEDHEALTHCARE INSURANCE COMPANY | $18K | $0 | $18K | 12.46% |
| JEFFREY D HARNED3 Filed as: JEFFREY D. HARNED | 13117 EASTPOINT PARK BOULEVARD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $599 | $22 | $621 | 1.91% |
| MJ INSURANCE3 Filed as: ALEX H. HALVARSON & VARIOUS AGENTS | 13117 EASTPOINT PARK BOULEVARD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $463 | $1 | $464 | 1.43% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 9700 ORNSBY STATION ROAD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $443 | $0 | $443 | 1.36% |
| ALIUM INSURANCE PARTNERS, LLC3 Filed as: ALIUM INSURANCE PARTNERS LLC | 137 BRECKENRIDGE LANE LOUISVILLE, KY 40207 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $273 | $0 | $273 | 0.84% |
| VICKIE E LEWIS3 Filed as: VICKIE E. LEWIS | 6558 STOVALL ROAD CAVE CITY, KY 42127 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $264 | $1 | $265 | 0.82% |
| LIG BENEFITS LLC3 | 10007 IVYBRIDGE CIRCLE LOUISVILLE, KY 40241 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $232 | $3 | $235 | 0.72% |
| DIANE MARIE JARBOE3 | 4315 FOEBURN LANE LOUISVILLE, KY 40207 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $102 | $0 | $102 | 0.31% |
| JEFFREY D HARNED3 Filed as: JEFFREY D. HARNED | 13117 EASTPOINT PARK BOULEVARD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $251 | $0 | $251 | 2.30% |
| MJ INSURANCE3 Filed as: RTR AL CORP AND VARIOUS AGENTS | 100 PROMENADE COURT LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $217 | $0 | $217 | 1.99% |
| ALIUM INSURANCE PARTNERS, LLC3 Filed as: ALIUM INSURANCE PARTNERS LLC | 137 BRECKENRIDGE LANE LOUISVILLE, KY 40207 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $117 | $0 | $117 | 1.07% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 9700 ORNSBY STATION ROAD LOUISVILLE, KY 40223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $40 | $0 | $40 | 0.37% |
| LIG BENEFITS LLC3 | 10007 IVYBRIDGE CIRCLE LOUISVILLE, KY 40241 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.31% |
| DIANE MARIE JARBOE3 | 4315 FOEBURN LANE LOUISVILLE, KY 40207 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 0.29% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.20% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 214 | $141K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 214 | $141K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 214 | $141K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 214 | $141K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 214 | $141K |
| Other(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 214 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.