| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRIS PULOS3 | 409 E MONUMENT AVE STE 400 DAYTON, OH 45402 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $21K | — | $21K | 4.07% |
| MELISSA DAVIS-LINDSEY3 | PO BOX 766 LEXINGTON, TN 38351 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | -$2K | — | -$2K | -0.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 409 EAST MONUMENT AVENUE DAYTON, OH 45402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $12K | — | $12K | 4.94% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $36 | $36 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 409 EAST MONUMENT AVENUE DAYTON, IL 45402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 409 E MONUMENT AVE DAYTON, OH 45402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 6.59% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 409 E MONUMENT AVE DAYTON, OH 45402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
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 | 447 | 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) | 447 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 98 | $524K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 719 | $239K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 719 | $239K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 558 | $93K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 447 | $72K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 558 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 719 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.