| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL BARCROFT3 | 6000 POPLAR AVE. STE. 300 MEMPHIS, TN 38119 | BLUECROSS BLUESHIELD OF TENNESSEE | $0 | $3K | $3K | 1.04% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE OF TN | PO BOX 2153 BIRMINGHAM, AL 35287 | UNUM | $2K | $8 | $2K | 14.64% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | $0 | $794 | $794 | 16.99% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | 1500 RIVERFRONT DRIVE LITTLE ROCK, AR 72202 | HARTFORD LIFE AND ACCIDENT | $701 | — | $701 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $247K |
| DELTA DENTAL EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $29K |
| CORPORATE PLANNING NETWORK EIN 62-1492665 THIRD PARTY ADMINISTRATO | Claims processing Service code 12 | — | $16K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $15K |
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 | 475 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 492 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE | 1,263 | $332K |
| Life insurance | GUARDIAN | 501 | $364K |
| Long-term disability | GUARDIAN | 501 | $364K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TENNESSEE | 1,263 | $332K |
| Other(3 contracts, 3 carriers) | GUARDIAN | 501 | $386K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,263 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.