| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 9648 KINGSTON PIKE STE 8 KNOXVILLE, TN 37922 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| NOT PROVIDED3 | 906 BRADFORD AVE NASHVILLE, TN 37204 | AFLAC | $3K | $262 | $3K | 11.14% |
| NOT PROVIDED3 | 541 N MOUNT JULIET RD STE 2201A MOUNT JULIET, TN 37122 | AFLAC | $489 | — | $489 | 1.78% |
| NOT PROVIDED3 | 3219 E CAMELBACK RD 396 PHOENIX, AZ 85018 | AFLAC | $482 | — | $482 | 1.75% |
| NOT PROVIDED3 | 541 N MOUNT JULIET RD STE 2201A MOUNT JULIET, TN 37122 | AFLAC | $424 | $52 | $476 | 1.73% |
| NOT PROVIDED3 | 1355 LYNNFIELD RD BLDG B SUITE 259 MEMPHIS, TN 38119 | AFLAC | $158 | $147 | $305 | 1.11% |
| NOT PROVIDED3 | 104 SHORT SPRINGS RD TULLAHOMA, TN 37388 | AFLAC | $176 | $52 | $228 | 0.83% |
| NOT PROVIDED3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $87 | $82 | $169 | 0.61% |
| NOT PROVIDED3 | 3219 E CAMELBACK RD 396 PHOENIX, AZ 85018 | AFLAC | $123 | — | $123 | 0.45% |
| NOT PROVIDED3 | 732 SILVER SANDS DR CORDOVA, TN 38018 | AFLAC | $85 | $29 | $114 | 0.41% |
| NOT PROVIDED3 | 1234 CALIFORNIA DR MURFRESSBORO, TN 37129 | AFLAC | $90 | — | $90 | 0.33% |
| NOT PROVIDED3 | PO BOX 151 MC COOL JUNCTION, NE 68401 | AFLAC | $39 | $29 | $68 | 0.25% |
| NOT PROVIDED3 | 14301 N 87TH ST STE 313 SCOTTSDALE, AZ 85260 | AFLAC | $63 | — | $63 | 0.23% |
| NOT PROVIDED3 | 2355 W PINNACLE PEAK RD STE 380 PHOENIX, AZ 85027 | AFLAC | $25 | $35 | $60 | 0.22% |
| NOT PROVIDED3 | PO BOX 40327 NASHVILLE, TN 37204 | AFLAC | $51 | — | $51 | 0.19% |
| NOT PROVIDED3 | 2000 MALLORY LANE SUITE 130-378 FRANKLIN, TN 37067 | AFLAC | $49 | — | $49 | 0.18% |
| NOT PROVIDED3 | 14301 N 87TH ST STE 313 SCOTTSDALE, AZ 85260 | AFLAC | $36 | $13 | $49 | 0.18% |
| NOT PROVIDED3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $43 | — | $43 | 0.16% |
| NOT PROVIDED3 | 34212 N 23RD GLEN PHOENIX, AZ 85085 | AFLAC | $36 | — | $36 | 0.13% |
| NOT PROVIDED3 | 14301 N 87TH ST STE 313 SCOTTSDALE, AZ 85260 | AFLAC | $17 | $13 | $30 | 0.11% |
| NOT PROVIDED3 | 108 NESTLEDOWN CROSSING BELL BUCKLE, TN 37020 | AFLAC | $20 | — | $20 | 0.07% |
| NOT PROVIDED3 | 2477 TITANS LN BRENTWOOD, TN 37027 | AFLAC | $19 | — | $19 | 0.07% |
| NOT PROVIDED3 | 113 POINT DRIVE TULLAHOMA, TN 37388 | AFLAC | $11 | — | $11 | 0.04% |
| DESERT INSURANCE ADVISORS LLC3 | 3219 E CAMELBACK RD #396 PHOENIX, AZ 85018 | AFLAC | $6 | — | $6 | 0.02% |
| NOT PROVIDED | 9292 E TOPEKA DR SCOTTSDALE, AZ 85255 | AFLAC | $5 | — | $5 | 0.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 9648 KINGSTON PIKE STE 8 KNOXVILLE, TN 37922 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 9648 KINGSTON PIKE STE 8 KNOXVILLE, TN 37922 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 9648 KINGSTON PIKE STE 8 KNOXVILLE, TN 37922 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $659 | — | $659 | 15.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 9648 KINGSTON PIKE KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $91 | $1K | 33.73% |
| SHARON MAY LINDSAY3 | 2911 STAGE RUN DRIVE HIXON, TN 37343 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | $282 | $456 | 12.40% |
| KATHERINE C ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37363 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $301 | $36 | $337 | 9.17% |
| MAX MARTIN LINDSAY3 | 2911 STAGE RUN DRIVE HIXSON, TN 37343 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $142 | $251 | 6.83% |
| VICKIE E LEWIS3 | 6558 STOVALL RD CAVE CITY, KY 42127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | $78 | $225 | 6.12% |
| DEBRA M DAVIS3 | 6796 MARTHAS PT MEMPHIS, TN 38141 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $186 | — | $186 | 5.06% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $11 | $42 | 1.14% |
| JOHN T ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37363 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.90% |
| SHAWN MARIE KING3 Filed as: SHAWN MARIE DAVIS | 6310 JUPITER AVENUE BARTLETT, TN 38134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $4 | $12 | 0.33% |
| J AUSTIN BAKER3 | PO BOX 770941 MEMPHIS, TN 38117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.27% |
| EMPLOYEE BENEFIT SOLUTIONS INC3 Filed as: EMPLOYEE BENEFIT SOLUTIONS LLC | 2785 MAYFIELD HWY BENTON, KY 42025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.16% |
| BOBBIE J WHITTAKER3 | 2530 SCOTTSVILLE ROAD BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.14% |
| PARRISH J PEACHEE3 | 201 W 103RD ST INDIANAPOLIS, IN 46290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.11% |
| NOT PROVIDED3 | 906 BRADFORD AVE NASHVILLE, TN 37204 | AFLAC | $78 | — | $78 | 2.38% |
| NOT PROVIDED3 | 34212 N 23RD GLEN PHOENIX, AZ 85085 | AFLAC | $43 | $24 | $67 | 2.04% |
| NOT PROVIDED3 | 3219 E CAMELBACK RD 396 PHOENIX, AZ 85018 | AFLAC | $33 | — | $33 | 1.01% |
| NOT PROVIDED3 | 15010 N 61ST PL SCOTTSDALE, AZ 85254 | AFLAC | $25 | — | $25 | 0.76% |
| NOT PROVIDED3 | 1234 CALIFORNIA DR MURFRESSBORO, TN 37129 | AFLAC | $24 | — | $24 | 0.73% |
| NOT PROVIDED3 | 6245 N 24TH PKWY SUITE 201 PHOENIX, AZ 85016 | AFLAC | $22 | — | $22 | 0.67% |
| NOT PROVIDED3 | PO BOX 40327 NASHVILLE, TN 37204 | AFLAC | $17 | — | $17 | 0.52% |
| NOT PROVIDED3 | 3219 E CAMELBACK RD 396 PHOENIX, AZ 85018 | AFLAC | $17 | — | $17 | 0.52% |
| NOT PROVIDED3 | 14301 N 87TH ST STE 313 SCOTTSDALE, AZ 85260 | AFLAC | $12 | $5 | $17 | 0.52% |
| NOT PROVIDED3 | 2000 MALLORY LANE SUITE 130-378 FRANKLIN, TN 37067 | AFLAC | $15 | — | $15 | 0.46% |
| NOT PROVIDED3 | 14301 N 87TH ST STE 319 SCOTTSDALE, AZ 85260 | AFLAC | $8 | $5 | $13 | 0.40% |
| NOT PROVIDED3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $12 | — | $12 | 0.37% |
| NOT PROVIDED3 | 3219 E CAMELBACK RD STE 396 PHOENIX, AZ 85018 | AFLAC | $11 | — | $11 | 0.34% |
| NOT PROVIDED3 | 2355 W PINNACLE PEAK RD STE 380 PHOENIX, AZ 85027 | AFLAC | $4 | $5 | $9 | 0.27% |
| NOT PROVIDED3 | 1194 E LAKEVIEW DR SAN TAN VALLEY, AZ 85143 | AFLAC | $7 | — | $7 | 0.21% |
| NOT PROVIDED3 | 950 W BANNOCK ST STE 1100 BOISE, ID 83702 | AFLAC | $7 | — | $7 | 0.21% |
| NOT PROVIDED3 | 2477 TITANS LN BRENTWOOD, TN 37027 | AFLAC | $5 | — | $5 | 0.15% |
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 | 170 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 143 | $35K |
| Short-term disability(3 contracts, 2 carriers) | AFLAC | 103 | $39K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 143 | $25K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 64 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.