| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | 6000 POPLAR AVE. STE. 300 MEMPHIS, TN 38119 | GUARDIAN | $0 | $6K | $6K | 1.88% |
| PAUL BARCROFT3 | 6000 POPLAR AVE. STE. 300 MEMPHIS, TN 38119 | BLUECROSS BLUESHIELD OF TENNESSEE | $0 | $3K | $3K | 1.09% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | P.O. BIX 2153 BIRMINGHAM, AL 35287 | UNUM | $2K | $281 | $2K | 16.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $241K |
| DELTA DENTAL EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $32K |
| CORPORATE PLANNING NETWORK EIN 62-1492665 THIRD PARTY ADMINISTRATO | Claims processing Service code 12 | — | $14K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $13K |
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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE | 1,249 | $315K |
| Life insurance | GUARDIAN | 474 | $343K |
| Long-term disability | GUARDIAN | 474 | $343K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TENNESSEE | 1,249 | $315K |
| Other(3 contracts, 3 carriers) | GUARDIAN | 476 | $357K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,249 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.