| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $412 | $7K | 6.68% |
| BUKATY COMPANIES3 Filed as: BUKATY COMPANIES, INC. | 4601 COLLEGE BOULEVARD, SUITE 100 LEAWOOD, KS 66211 | METROPOLITAN LIFE INSURANCE COMPANY | $456 | $585 | $1K | 1.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $691 | $691 | 0.68% |
| HOUCHENS INSURANCE GROUP INC3 Filed as: HOUCHENS INSURANCE GROUP, INC. | 1240 FAIRWAY STREET BOWLING GREEN, KY 42103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $410 | $6K | 5.99% |
| JODY DAN BRYANT3 | 1429 MOUNT AYR CIRCLE BOWLING GREEN, KY 42103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.87% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $360 | $2K | 1.74% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH S. GOLDEN | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $204 | $2K | 1.69% |
| MJ INSURANCE3 Filed as: DAVID PURVIS AND VARIOUS AGENTS | 3840 SADDLE BEND DRIVE OLIVE BRANCH, MS 38654 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $94 | $2K | 1.57% |
| FRANKIE GLEE WILLIAMS3 | 206 HURRICANE SHORES ROAD SCOTTSVILLE, KY 42164 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $949 | $223 | $1K | 1.21% |
| VIOLET P COOTS3 Filed as: VIOLET P. COOTS | 1410 WHALEN ROAD BOWLING GREEN, KY 42101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $877 | $90 | $967 | 1.00% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 300 WICHITA, KS 67202 | THE DENTAL CONCERN, INC. | $2K | $0 | $2K | 5.84% |
| HOUCHENS INSURANCE GROUP INC3 Filed as: HOUCHENS INSURANCE GROUP, INC. | 1750 SCOTTSVILLE ROAD, SUITE 4 BOWLING GREEN, KY 42104 | THE DENTAL CONCERN, INC. | $725 | $365 | $1K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 EAST CARMEL DRIVE, SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $3K | $6K | 20.00% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 24.93% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $967 | $0 | $967 | 18.91% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $447 | $0 | $447 | 8.74% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $447 | $0 | $447 | 8.74% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $46 | $0 | $46 | 0.90% |
| BRIAN OBAL3 | 3190 FAIRVIEW PARK DRIVE, SUITE 40 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $41 | $41 | 0.80% |
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 | 284 | 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) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $132K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $132K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $131K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $198K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $131K |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.