| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL BARTON3 | 903 MURFREESBORO ROAD FRANKLIN, TN 37065 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $25K | $0 | $25K | 4.35% |
| ANDREWS M. DARTINGTON3 | PO BOX 4539 JOHNSON CITY, TN 37602 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $5K | $0 | $5K | 0.93% |
| MICHAEL TROUT3 | 117 REGIONAL PARK DRIVE KINGPORT, TN 37660 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $4K | $0 | $4K | 0.75% |
| USI INSURANCE SERVICES LLC3 | PO BOX 680639 FRANKLIN, TN 37068 | DELTA DENTAL OF TENNESSEE | $45K | $0 | $45K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 9394 WEST DODGE ROAD, SUITE 250 OMAHA, NE 68114 | STANDARD INSURANCE COMPANY | $50K | $0 | $50K | 17.12% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $30K | $0 | $30K | 10.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | STANDARD INSURANCE COMPANY | $16K | $0 | $16K | 5.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 10018 | STANDARD INSURANCE COMPANY | $481 | $0 | $481 | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.22% |
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 | 478 | 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) | 478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 186 | $571K |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,207 | $1.0M |
| Vision(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 518 | $635K |
| Life insurance | STANDARD INSURANCE COMPANY | 478 | $290K |
| Short-term disability | STANDARD INSURANCE COMPANY | 478 | $290K |
| Long-term disability | STANDARD INSURANCE COMPANY | 478 | $290K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 186 | $571K |
| Other | STANDARD INSURANCE COMPANY | 478 | $290K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,207 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.