| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH RIDEOUT3 | 12 CADILLAC DRIVE, STE 160 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $137K | — | $137K | 3.17% |
| 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 | $41K | $14K | $55K | 13.37% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $6K | — | $6K | 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 | 380 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 744 | $4.3M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 382 | $410K |
| Vision | VISION SERVICE PLAN | 339 | $59K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 457 | $276K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 457 | $276K |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 457 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 744 | — |
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.