| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRUCE SAMMIS3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | BLUE CROSS AND BLUE SHIELD OF TENNESSEE, INC. | $120K | $0 | $120K | 3.05% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $28K | $5K | $33K | 11.83% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 0.45% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | DELTA DENTAL OF TENNESSEE | $20K | $0 | $20K | 9.24% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | $0 | $8K | 14.32% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 73512 | VISION SERVICE PLAN | $5K | — | $5K | 10.02% |
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 | 258 | 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) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF TENNESSEE, INC. | 570 | $3.9M |
| Dental | DELTA DENTAL OF TENNESSEE | 562 | $219K |
| Vision | VISION SERVICE PLAN | 243 | $50K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 258 | $277K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 258 | $277K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 258 | $277K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF TENNESSEE, INC. | 570 | $3.9M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 599 | $343K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 599 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.