| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD NASHVILLE, TN 37214 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $22 | $22 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE, INC. | 565 MARRIOTT DRIVE SUITE 500 NASHVILLE, TN 37214 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $7 | $7 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE | 26 CENTURY BLVD NASHVILLE, TN 37214 | AETNA LIFE INSURANCE CO. | $10K | — | $10K | 0.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | PO BOX 305025 NASHVILLE, TN 37230 | EYEMED VISION CARE ON BEHALF OF FIDELITY SEC. LIFE INSURANC CO | $6K | — | $6K | 5.95% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TN | 565 MARRIOTT DRIVE SUITE 500 NASHVILLE, TN 37214 | EYEMED VISION CARE ON BEHALF OF FIDELITY SEC. LIFE INSURANC CO | $4K | — | $4K | 4.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE, INC. | 3343 PERIMETER HILL DRIVE SUITE 214 NASHVILLE, TN 37211 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $402 | $260 | $662 | 20.23% |
| THE MATHIS-HILL-ROBERTSON AGENCY3 Filed as: THE MATHIS-HILL ROBERTSON AGENCY | 5040 ROSWELL ROAD SUITE 100 ATLANTA, GA 30342 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8 | — | $8 | 0.24% |
| WILLIAM DONOVAN3 | 2142 BROOKWOOD LANE MURFREESBORO, TN 37129 | HYATT LEGAL PLANS | $61 | — | $61 | 13.03% |
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 | 27 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 56 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1,124 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,122 | $9.5M |
| Dental | DELTA DENTAL OF TENNESSEE | 2,318 | $703K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SEC. LIFE INSURANC CO | 1,911 | $97K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,401 | $1.1M |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,401 | $1.1M |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,401 | $1.1M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 1,401 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,318 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.