| 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% |
| 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 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $162 | $3K | 33.27% |
| KATHERINE ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37363 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $604 | $73 | $677 | 8.29% |
| SHARON MAY LINDSAY3 | 2911 STAGE RUN DRIVE HIXON, TN 37343 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $388 | $271 | $659 | 8.07% |
| DEBRA M DAVIS3 Filed as: DEBRA DAVIS | 6796 MARTHAS PT MEPHIS, TN 38141 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $460 | — | $460 | 5.63% |
| VICKIE E LEWIS3 Filed as: VICKIE LEWIS | 6558 STOVALL RD CAVE CITY, KY 42127 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $327 | $105 | $432 | 5.29% |
| MAX MARTIN LINDSAY3 | 2911 STAGE RUN DRIVE HIXON, TN 37343 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $236 | $88 | $324 | 3.97% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $94 | $34 | $128 | 1.57% |
| JOHN T ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37363 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.82% |
| J AUSTIN BAKER3 | PO BOX 770941 MEPHIS, TN 38117 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $13 | $32 | 0.39% |
| SHAWN MARIE KING3 Filed as: SHAWN MARIE DAVIS | 6310 JUPITER AVENUE BARTLETT, TN 38134 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $11 | $30 | 0.37% |
| EMPLOYEE BENEFIT SOLUTIONS INC3 Filed as: EMPLOYEE BENEFIT SOLUTIONS | 2785 MAYFIELD HWY BENTON, KY 42025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $3 | $13 | 0.16% |
| BOBBIE J WHITTAKER3 Filed as: BOBBIE WHITTAKER | 2530 SCOTTSVILLE ROAD BOWLING GREEN, KY 42104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $2 | $12 | 0.15% |
| PARRISH J PEACHEE3 Filed as: PARRISH PEACHEE | 201 W 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.12% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 9648 KINGSTON PIKE STE 8 KNOXVILLE, TN 37922 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $696 | — | $696 | 15.01% |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | 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 | 151 | $44K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 33 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $27K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 64 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.