| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALEX WADE3 | P.O. BOX 150229 NASHVILLE, TN 37215 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $50K | — | $50K | 2.02% |
| KEVIN N KELSEY3 | 3000 MERIDIAN BLVD STE 100 FRANKLIN, TN 37067 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $31K | — | $31K | 1.23% |
| PAULINE BARNES3 | P.O. BOX 150229 NASHVILLE, TN 37215 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $1K | — | $1K | 0.06% |
| LEVINE GROUP LLC3 | 5141 VIRGINIA WAY SUITE 370 BRENTWOOD, TN 37027 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 12.89% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 497 | $2.5M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 497 | $2.5M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 497 | $2.5M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $84K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $84K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $84K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 497 | — |
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.