| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD SMITH3 | 2158 NORTHGATE PARK LANE STE 405 CHATTANOOGA, TN 37415 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $11K | — | $11K | 2.76% |
| EDWARD E MCCUISTION3 Filed as: EDWARD MCCUISTON | 1827 CREEK WAY DR OOLTEWAH, TN 37363 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $9K | — | $9K | 2.31% |
| HAZEN MIRTS3 | 6712 DEANE HILL DR STE A KNOXVILLE, TN 37919 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $7K | — | $7K | 1.62% |
| RICHARD D BARRY Filed as: RICHARD BERRY | 4710 CREAK POINT LANE SIGNAL MOUNTAIN, TN 37377 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $1K | — | $1K | 0.32% |
| FINANCIAL PLANNING ASSOCIATES, LLC3 Filed as: FINANCIAL PLANNING ASSOCIATES | 5726 MARLIN ROAD SUITE 212 CHATTANOOGA, TN 37411 | DELTA DENTAL OF TENNESSEE | $4K | — | $4K | 4.59% |
| EDWARD SMITH3 | 2158 NORTHGATE PARK LANE BLDG 2, SUITE 405 CHATTANOOGA, TN 37415 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.51% |
| EDWARD E MCCUISTION3 Filed as: EDWARD MCCUISTION | 1827 CREEK WAY DRIVE OOLTEWAH, TN 37363 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 8.40% |
| RICHARD D BARRY3 Filed as: RICHARD BARRY | 4710 CREEK POINT LN SIGNAL MOUNTAIN, TN 37377 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.60% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $92 | $92 | 0.25% |
| FINANCIAL PLANNING ASSOCIATES, LLC3 | 5726 MARLIN RD STE 212 CHATTANOOGA, TN 37411 | VISION SERVICE PLAN | $813 | — | $813 | 3.34% |
| EDWARD SMITH3 | 2158 NORTHGATE PARK LANE CHATTANOOGA, TN 37415 | VISION SERVICE PLAN | $423 | — | $423 | 1.74% |
| EDWARD SMITH3 | 2158 NORTHGATE PARK LANE BUILDING 2 STE 405 CHATTANOOGA, TN 37415 | COMPANION LIFE INSURANCE | $4K | — | $4K | 54.52% |
| EDWARD E MCCUISTION3 | 1827 CREEK WAY DR OOLTEWAH, TN 37363 | COMPANION LIFE INSURANCE | $3K | — | $3K | 38.96% |
| MITCH BESVINICK3 | 1280 BRIGHTON WAY NEW TOWN SQUARE, PA 19073 | COMPANION LIFE INSURANCE | $762 | — | $762 | 10.11% |
| RICHARD D BARRY3 Filed as: RICHARD BARRY | 4710 CREEK POINT LANE SIGNAL MOUNTAIN, TN 37377 | COMPANION LIFE INSURANCE | $734 | — | $734 | 9.74% |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 100 | $405K |
| Dental | DELTA DENTAL OF TENNESSEE | 276 | $98K |
| Vision | VISION SERVICE PLAN | 135 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $37K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $37K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.