| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD SIMS3 | PO BOX 10328 KNOXVILLE, TN 37939 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $25K | — | $25K | 6.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | 1900 WINSTON ROAD SUITE 100 KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 6.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 4.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | SYMETRA LIFE INSURANCE COMPANY | $3K | $579 | $4K | 9.98% |
| LIPSCOMB & PITTS INSURANCE LLC3 Filed as: LIPSCOMB AND PITTS INSURANCE L | 2670 UNION AVENUE EXTENDED SUITE 200 MEMPHIS, TN 38112 | SYMETRA LIFE INSURANCE COMPANY | — | $627 | $627 | 1.60% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | SYMETRA LIFE INSURANCE COMPANY | — | $352 | $352 | 0.90% |
| TENNESSEE AUTOMOTIVE ASSOC3 Filed as: TENNESSEE INSURANCE SERVICES | — | TELADOC | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES | — | COMBINED INSURANCE | $235 | — | $235 | 14.34% |
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 | 255 | 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) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 134 | $871K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 255 | $123K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 255 | $123K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 255 | $123K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 88 | $461K |
| Other(5 contracts, 5 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 255 | $647K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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."
No prospect flags tripped on this filing.