| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALAN LEVITZ3 | 3000 LAKESIDE DR STE 200S BANNOCKBURN, IL 60015 | BLUERE OF TENNESSEE | $20K | — | $20K | 1.69% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL INC | THREE PARKWAY NORTH, SUITE 500 DEERFIELD, IL 60015 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $63K | — | $63K | 11.09% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $7K | $7K | 1.28% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL INC | THREE PARKWAY NORTH, SUITE 500 DEERFIELD, IL 60015 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $28K | — | $28K | 10.94% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 0.96% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL INC | THREE PARKWAY NORTH DEERFIELD, IL 60015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.37% |
| STEPHANIE L HERRING3 | 363 #2 RIVERBLUFF PLACE MEMPHIS, TN 38103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.33% |
| LIPSCOMB & PITTS INSURANCE LLC3 Filed as: LIPSCOMB & PITTS INS LLC | 2670 UNION AVE EXTD MEMPHIS, TN 38112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.82% |
| MICHAEL BLOCK3 | 16619 S. PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $471 | $2K | 1.38% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $597 | $251 | $848 | 0.72% |
| ERIN COLLEEN LANINGA3 | 1700 HIGGINS DES PLAINES, IL 60018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $511 | $20 | $531 | 0.45% |
| BENEFITS FIRST LLC3 | P O BOX 766 LEXINGTON, TN 38351 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | — | $211 | 0.18% |
| KERRY D FILER3 | PO BOX 39 COLLIERVILLE, TN 38027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | — | $102 | 0.09% |
| EMILY COPELAND3 | PO BOX 453 MIDDLETON, TN 38052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.04% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $3 | $47 | 0.04% |
| ANGELA MARCOS3 | 3306 KIRKWOOD DR RAPID CITY, SD 57702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $23 | $38 | 0.03% |
| KRISTEN BIBLE3 | 4516 LATROBE COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.03% |
| J AUSTIN BAKER3 | PO BOX 770941 MEMPHIS, TN 38117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.03% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.03% |
| JOSEPH MCDONALD3 | 12052 PEPPERMILL LANE NW PICKERINGTON, OH 43147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.03% |
| JUSTIN J MCDONALD3 | 12052 PEPPERMILL LANE PICKERINGTON, OH 43147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.02% |
| DAVID HAMPTON3 | 4910 W ARLINGTON PARK BLVD FT WAYNE, IN 46835 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| VINSON K ELLENBERG3 | 905 ADAIR AVE NE ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.02% |
| SUSAN FONTANA FLYNN3 | 8814 EAGLE POINT DRIVE KNOXVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.02% |
| FREDDIE L POWERS3 | 1910 SHADOW ROCK KINGWOOD, TX 77339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.02% |
| PARRISH J PEACHEE3 | 201 W 103RD ST INDIANAPOLIS, IN 46290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $5 | $22 | 0.02% |
| JUDGE BLOUNT3 | 2407 SOUTH SHORE DR BILOXI, MS 39532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| GLENN ZIMMERMAN INC3 | 1510 HIGH ROCK RD GIBSONVILLE, NC 27249 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| ENID CHANDLER3 | 4736 W NAPOLEON AVE METARIE, LA 70001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES MICHAEL EMIDY | PO BOX 2021 RIDGELAND, MS 39158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| PROFESSIONAL ENROLLMENTS INC3 | 821 KING'S GRANT ST SIMON ISLAND, GA 31522 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $3 | $14 | 0.01% |
| JONITA ANGELA OAKES3 | PO BOX 256 TROUP, TX 75789 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| EMMA ANN DEAN3 | 350 SOUTH BELVEDERE DRIVE HAMPSTEAD, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE MARIE STUEMKY | PO BOX 5014 BUFFALO CREEK, CO 80425 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $1 | $7 | 0.01% |
| DALE T BUTLER3 | 15234 REEDS STREET OVERLAND PARK, KS 66223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JAMES M EANES3 | 1700 E JACKSON ST PENSACOLA, FL 32501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.01% |
| FELTER INC3 | 5403 COMMONWEALTH AVE WESTERN SPRINGS, IL 60558 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| KLINGBEIL AND ASSOCIATES INC3 | 6000 LAKE FORREST DRIVE ATLANTA, GA 30328 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.00% |
| BRAD BIEL3 | 2 GOLD ST NEW YORK, NY 10038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $3 | $4 | 0.00% |
| MARILYNN DECKER3 | 5173 JOHN HAGAR RD HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| BRENDA GAIL PATE3 Filed as: BRENDA KNIGHT | 821 KING'S GRANT ST SIMON ISLAND, GA 31522 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| WALTER H MODARELLI3 | 11502 CARROLLWOOD DR TAMPA, FL 33618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| THE WORKSIGHT GROUP LLC3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| KENNETH B BOYLES3 | PO BOX 7120 THE WOODLANDS, TX 77387 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CAPSTONE BENEFIT SOLUTIONS LLC3 | 901 LAKESIDE CIRCLE LEWISVILLE, TX 75057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JUDY L CHANDLER3 | 8831 HEISKELL ROAD POWELL, TN 37849 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GRAEM M CLARK3 | 589 WINDMERE DR LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| COACH CONCEPTS INC3 | 9500 KOGER BLVD ST PETERSBURG, FL 33702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| WILLIAM J. LAMMEL3 Filed as: WILLIAM W DRAPER III | 5326 PANDA LN MEMPHIS, TN 38120 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JOE FERNANDEZ3 | 1201 ELM ST STE 4250 DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| VICTORIA L FLYNN3 | 7009 FAIRVIEW RD CORRYTON, TN 37721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JACQUELYN D FOWLER3 | 196 GRAY HAWK DRIVE SHELBYVILLE, KY 40065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARK F BARRETT LLC3 | 14141 46TH STREET NORTH CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| TOMMY L MILLER3 | 713 MOUNTAIN OAK PARKWAY STONE MOUNTAIN, GA 30087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| OPTIO LLC3 | 8547 E ARAPAHOE RD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| PNC FINANCIAL ENTERPRISES INC3 | 1841 N SHERRY DR ATLANTIC BEACH, FL 32233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| WAYNE RIMMER3 | 7454 FARMERS RD PENSACOLA, FL 32526 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: PATRICK MICHAEL ROGERS | 137 CAMELOT CIRCLE CORAOPOLIS, PA 15108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GERALD A SANFTNER3 | 3306 KIRKWOOD DR RAPID CITY, SD 57702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| J SHANNON SHEPPARD3 | 4279 MELWOOD OAK DR LAKELAND, TN 38002 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARK WEBER3 | 2011 HAMPTON ST PITTSBURGH, PA 15218 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ALAN LEVITZ3 | 3000 LAKESIDE DR STE 200S BANNOCKBURN, IL 60015 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $10K | — | $10K | 9.92% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL INC | THREE PARKWAY NORTH, SUITE 500 DEERFIELD, IL 60015 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $1K | $7K | 13.64% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $509 | $509 | 1.02% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL INC | THREE PARKWAY NORTH, SUITE 500 DEERFIELD, IL 60015 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $68 | — | $68 | 10.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 | Direct payment from the plan; Contract Administrator Service code 13 | — | $644K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 | Direct payment from the plan; Non-monetary compensation; Contract Administrator; Other services; Float revenue; Named fiduciary; Claims processing; Participant communication Service code 12 | — | $60K |
| MEDCOM SERVICES, INC. EIN 59-2316866 | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $16K |
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 | 1,339 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUERE OF TENNESSEE | 2,549 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 242 | $29K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 2,252 | $101K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,494 | $570K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 567 | $255K |
| Other(5 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,494 | $766K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,549 | — |
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.