| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE | 6000 POPLA AVE., STE 300 MEMPHIS, TN 38119 | BLUE CROSS BLUE SHIELD OF TENNESSEE | — | $17K | $17K | 3.25% |
| JAMES PEW3 Filed as: JAMES BROGLEN | 1465 E. JOYCE BLVD. STE 200 FAYETTEVILLE, AR 72701 | BLUE CROSS BLUE SHIELD OF TENNESSEE | — | $10K | $10K | 1.96% |
| VISION SERVICE PLAN3 | — | VISION SERVICE PLAN | — | $14K | $14K | 22.56% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 2211 7TH AVE. SOUTH BIRMINGHAM, AL 35233 | UNUM | $3K | — | $3K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES,INC. | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | $988 | — | $988 | 16.99% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 1500 RIVERFRONT DR. LITTLE ROCK, AR 72202 | HARTFORD LIFE AND ACCIDENT | $872 | — | $872 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $300K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $33K |
| CORPORATE PLANNING NETWORK EIN 62-1492665 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $19K |
| RXBENEFITS EIN 63-1157085 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $10K |
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 | 488 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 515 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TENNESSEE | 1,353 | $511K |
| Vision | VISION SERVICE PLAN | 516 | $62K |
| Life insurance | GUARDIAN | 541 | $419K |
| Long-term disability | GUARDIAN | 541 | $419K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF TENNESSEE | 1,353 | $511K |
| Other(3 contracts, 3 carriers) | GUARDIAN | 541 | $444K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,353 | — |
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.