| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A LEVY3 Filed as: ROBERT ROUSSEL | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $48K | — | $48K | 3.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $1K | $12K | 11.43% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $2K | $11K | 18.17% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 18.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $1K | $8K | 17.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $545 | $2K | 13.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 18.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 17.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $386 | $2K | 18.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 43.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 44.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $903 | — | $903 | 30.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $836 | — | $836 | 38.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $236 | — | $236 | 16.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $288 | — | $288 | 19.78% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $576 | — | $576 | 40.17% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $264 | — | $264 | 26.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $219 | — | $219 | 25.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $232 | — | $232 | 34.99% |
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 | 248 | 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) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 183 | $1.3M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $102K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $16K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 242 | $73K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $46K |
| Other(17 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 242 | $323K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.