| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDY WILLIAMS3 | PO BOX 1395 CLEVELAND, TN 37364 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $48K | $0 | $48K | 4.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $2K | $16K | 14.45% |
| JENNON CARUTH3 | 7825 WASHINGTON AVE S STE 710 MINNEAPOLIS, MA 554392440 | METROPOLITAN LIFE INSURANCE COMPANY | -$198 | $317 | $119 | 0.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINATTI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | -$265 | $92 | -$173 | -1.20% |
| JENNON CARUTH3 | 7825 WASHINGTON AVE S STE 710 MINNEAPOLIS, MN 554392440 | METROPOLITAN LIFE INSURANCE COMPANY | -$324 | $293 | -$31 | -0.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | -$297 | $86 | -$211 | -1.89% |
| JENNON CARUTH3 | 7825 WASHINGTON AVE S STE 710 MINNEAPOLIS, MN 554392440 | METROPOLITAN LIFE INSURANCE COMPANY | -$144 | $356 | $212 | 15.40% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | -$202 | $101 | -$101 | -7.33% |
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 | 656 | 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) | 656 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 268 | $1.2M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 268 | $1.2M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 268 | $1.2M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 380 | $108K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 380 | $108K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 380 | $108K |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 380 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.