| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH RIDEOUT3 Filed as: KENNETH L RIDEOUT | 12 CADILLAC DRIVE SUITE 160 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $36K | — | $36K | 4.72% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 12 CADILLAC DRIVE SUITE 160 BRENTWOOD, TN 37027 | DELTA DENTAL OF TENNESSEE | $6K | — | $6K | 10.00% |
| DONALD HURWITZ3 Filed as: DONALD S HURWITZ | 1600 DIVISION ST SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $3K | $650 | $3K | 6.66% |
| CHARLES ROBERT PRUETT3 | 1600 DIVISION ST SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $516 | $62 | $578 | 1.19% |
| DONALD HURWITZ3 Filed as: DONALD S HURWITZ | 1600 DIVISION ST SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $4K | $985 | $5K | 10.39% |
| CHARLES ROBERT PRUETT3 | 1600 DIVISION ST SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $782 | $94 | $876 | 1.86% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $331 | $6K | 15.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 12 CADILLAC DRIVE SUITE 160 BRENTWOOD, TN 37027 | DELTA DENTAL OF TENNESSEE | $1K | — | $1K | 10.00% |
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 | 156 | 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. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 163 | $763K |
| Dental(3 contracts, 3 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 234 | $866K |
| Vision(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 245 | $776K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 234 | $39K |
| Short-term disability | NORTHWESTERN MUTUAL | 127 | $49K |
| Long-term disability | NORTHWESTERN MUTUAL | 127 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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.