| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL DAVIS3 Filed as: MICHAEL J LEVINE | 5141 VIRGINIA WAY STE 370 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE INC. | $78K | $0 | $78K | 3.03% |
| LEVINE GROUP LLC3 | 5141 VIRGINIA WAY STE 370 BRENTWOOD, TN 37027 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $3K | $19K | 5.48% |
| LEVINE GROUP LLC3 | 5141 VIRGINIA WAY STE 370 BRENTWOOD, TN 37027 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $202 | $4K | 20.45% |
| LEVINE GROUP LLC3 | 5141 VIRGINIA WAY STE 370 BRENTWOOD, TN 37027 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $234 | $4K | 20.75% |
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 | 240 | 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) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE INC. | 496 | $2.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 511 | $343K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 511 | $343K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 511 | $343K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 511 | $343K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 511 | $343K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 511 | $343K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 511 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.