| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CIS INSURANCE & INVESTMENTS3 Filed as: CIS INS AND INVESTMENTS PARTNERS LL | 550 S 5TH ST STE 303 LOUISVILLE, KY 40202 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $204K | $400 | $205K | 2.27% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | PO BOX 896620 CHARLOTTE, NC 28289 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $95K | $60 | $95K | 1.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPSTONE ADMINISTRATORS EIN 35-2260019 NONE | Direct payment from the plan; Contract Administrator; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 10 | — | $212K |
| KENTUCKY ASSOCIATION OF MANUFACTURE EIN 61-0122700 PLAN SPONSOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $83K |
| KAM SERVICES LLC EIN 20-0401331 PLAN SPONSOR AFFILIATE | Direct payment from the plan; Consulting (general) Service code 16 | — | $22K |
| ALLIED ADVISORS GROUP, LLC EIN 82-3486640 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
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 | 1,163 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 1,200 | $9.4M |
| Dental(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 1,200 | $9.0M |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 1,200 | $9.0M |
| Prescription drug(2 contracts) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 1,200 | $9.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,200 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.