| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2443 SIR BARTON WAY SUITE 400 LEXINGTON, KY 40509 | AMERICAN UNITED LIFE INSURANCE COMPANY | $108K | — | $108K | 12.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21031 | AMERICAN UNITED LIFE INSURANCE COMPANY | $14K | $38K | $51K | 5.67% |
| PHILIP C FREEMAN3 | 1945 SCOTTSVILLE ROAD SUITE 100 BOWLING GREEN, KY 42104 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $10K | — | $10K | 1.42% |
| ASSURED NL INS SVCS INC.3 Filed as: ASSURED NL INS AGCY INC | 5905 EAST GALBRAITH ROAD SUITE 500 CINCINNATI, OH 45236 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $28K | — | $28K | 5.65% |
| ROBBINS STAR3 | PO BOX 1007 LONDON, KY 40744 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19K | — | $19K | 3.87% |
| VMI ACQUISITION INC3 | 109 INTERNATIONAL DRIVE FRANKLIN, TN 37067 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 0.88% |
| PATTON ROBERT W3 | PO BOX 1007 LONDON, KY 40741 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $301 | — | $301 | 0.06% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL | 4500 TOWN CENTER BLVD JEFFERSONVILLE, IN 47130 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $60K | — | $60K | 15.66% |
| STARLENA A ROBBINS3 | 5959 KEAVY ROAD - PO BOX 1007 LONDON, KY 40744 | TRUSTMARK INSURANCE COMPANY | $15K | — | $15K | 5.39% |
| ASSURED BENEFITS INC3 Filed as: ASSURED INSURANCE | 1925 FREDERICA STREET OWENSBORO, KY 42301 | TRUSTMARK INSURANCE COMPANY | $8K | — | $8K | 2.75% |
| ASSURED NL INS SVCS INC.3 Filed as: ASSURED NL INS AGCY INC | 5905 EAST GALBRAITH ROAD SUITE 5000 CINCINNATI, OH 45236 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $39K | — | $39K | 18.72% |
| FREEMAN, PHILIP3 | 5905 EAST GALBRAITH ROAD SUITE 5000 CINCINNATI, OH 45236 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | -$1 | — | -$1 | -0.00% |
| ASSURED NEACE LUKENS INS. AGENCY3 Filed as: ASSURED NEACE LUKENS INSURANCE | 2305 RIVER ROAD LOUISVILLE, KY 40206 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 4.95% |
| AMERICAN BUSINESS SERVICES INC3 | 466 SYNNYSLOPE DR HUMBOLDT, TN 38343 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $623 | — | $623 | 2.68% |
| GREGORY H GRAY3 | 2440 SUNRISE AVE CULLEOKA, TN 38451 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $500 | — | $500 | 2.15% |
| WILLIAM JONES3 Filed as: WILLIAM D JONES | 958 COLLETT AVE STE 200 BOWLING GREEN, KY 42101 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $264 | — | $264 | 1.13% |
| STAR ROBBINS3 | PO BOX 1007 LONDON, KY 40743 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $67 | — | $67 | 0.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CLAIMS ADMINISTRATION | Contract Administrator Service code 13 | — | $613K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $35K |
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 | 876 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 67 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 949 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,799 | $702K |
| Vision | EYEMED VISION CARE | 1,782 | $61K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 876 | $1.3M |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 0 | $901K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 0 | $901K |
| Other(4 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 548 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,799 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.