| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASHLEY INSURANCE GROUP3 | 165 JACKSON STREET SANDUSKY, OH 44870 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $13K | $28K | 6.73% |
| FIFTH THIRD INSURANCE AGENCY INC3 Filed as: FIFTH THIRD INSURANCE AGENCY | 9700 ORMSBY STATION ROAD SUITE 200 LOUISVILLE, KY 40223 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 1.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 ADMIN/NETWORK PHARMACY | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $373K |
| ASHLEY INSURANCE GROUP LTD | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $31K |
| INGENIORX, INC. EIN 82-3062245 ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Other services Service code 12 | — | -$29K |
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 | 273 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 548 | $324K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 548 | $742K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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."
No prospect flags tripped on this filing.