| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 413 NORTH SHORE DRIVE SW KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $21K | $9K | $31K | 16.87% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, KY 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 10.34% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, KY 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, KY 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, KY 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 9.91% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, KY 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, KY 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 7.50% |
| MARSH & MCLENNAN AGENCY LLC3 | 1031 W 4TH AVE SUITE 400 ANCHORAGE, AK 99501 | AFLAC | $8K | — | $8K | 33.02% |
| PAMELA ROWSEY LARSON3 | 801 LAUDERDALE DR LEXINGTON, KY 40515 | AFLAC | $5K | — | $5K | 19.04% |
| LAURA BETH KELLER3 | 445 MADISON POINT DR LEXINGTON, KY 40515 | AFLAC | $278 | — | $278 | 1.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS/ADMIN | Claims processing; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $117K |
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 | 300 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 279 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 235 | $183K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 235 | $183K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $50K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $47K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $74K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.