| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | PO BOX 904037 CHARLOTTE, NC 28290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | — | $19K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | PO BOX 904037 CHARLOTTE, NC 28290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | — | $18K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 806 TYVOLA RD STE 108 CHARLOTTE, NC 28217 | VISION SERVICE PLAN | $3K | — | $3K | 2.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | PO BOX 904037 CHARLOTTE, NC 28290 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | — | $10K | 9.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & ASSOCIATES | PO BOX 381708 MEMPHIS, TN 38138 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 7.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD NASHVILLE, TN 37214 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $591 | $3K | 14.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | PO BOX 19820 KNOXVILLE, TN 37939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $93 | $382 | $475 | 2.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 806 TYVOLA RD SUITE 108 CHARLOTTE, NC 28217 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO | — | $31 | $31 | 0.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC. | JP MORGAN LOCKBOX 905601 806 TYVOLA RD, SUITE 108 CHAROLTTE, NC 282173538 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 29982 NETWORK PLACE CHICAGO, IL 60673 | NATIONWIDE LIFE INSURANCE | $515 | — | $515 | 10.00% |
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD SUITE 401 AUSTIN, TX 78726 | NATIONWIDE LIFE INSURANCE | $386 | — | $386 | 7.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 26 CENTURY BLVD NASHVILLE, TN 37214 | KANSAS CITY LIFE INSURANCE COMPANY | $329 | — | $329 | 11.86% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CP BROWN AND ASSOCIATES, LLC | 1770 KIRBY PKWY SUITE 320 MEMPHIS, TN 38183 | KANSAS CITY LIFE INSURANCE COMPANY | $72 | — | $72 | 2.60% |
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 | 1,271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONWIDE LIFE INSURANCE | 1,645 | $5K |
| Vision | VISION SERVICE PLAN | 907 | $152K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 9,878 | $301K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 4 | $3K |
| Long-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,271 | $209K |
| Other(6 contracts, 6 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,645 | $260K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,878 | — |
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.