| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH RIDEOUT3 | 12 CADILLAC DRIVE, STE 160 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $128K | — | $128K | 3.15% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 951 YAMATO RD. STE 200W BOCA RATON, FL 33431 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $45K | $6K | $52K | 11.42% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 452632886 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $43K | — | $43K | 12.73% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $6K | — | $6K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ | PO BOX 632886 CINCINNATI, OH 452632886 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $77 | — | $77 | 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 | 789 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 789 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 789 | $4.0M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 402 | $454K |
| Vision(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 789 | $4.1M |
| Life insurance(2 contracts) | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 494 | $335K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 494 | $334K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 494 | $334K |
| Other(2 contracts) | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 494 | $335K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 789 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.