| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COURTNEY E NELSON3 | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $105K | — | $105K | 3.52% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DR STE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.58% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.42% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 13.00% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DR STE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.60% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.40% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 13.00% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DR STE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.62% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.38% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 17.00% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $746 | — | $746 | 8.00% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DR STE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $237 | $237 | 2.54% |
| BROWN & BROWN INSURANCE SERVICES5 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 N FRANKLIN ST STE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $229 | $229 | 2.45% |
No Schedule C service providers reported on this filing.
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 390 | $3.0M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 390 | $3.0M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 390 | $3.0M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 283 | $77K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $74K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $70K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 283 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.