| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH LACHER3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $37K | — | $37K | 7.40% |
| ANITA BLACKMER3 Filed as: ANITA K BLACKMER | 3011 ARMORY DRIVE STE 250 NASHVILLE, TN 37204 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $0 | — | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | DBA HUB INTERNATIONAL MID-SOUTH NASHVILLE, TN 37230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $273 | $4K | 8.02% |
| DEBBIE PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $787 | $3K | 5.97% |
| LISA JENNETTE UNDERHILL3 | 1296 RED OAK DR BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $29 | $1K | 2.98% |
| LYNN MARIE BARRY3 | 301 W PARK AVE LANGHORNE, PA 19047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $671 | $150 | $821 | 1.73% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $388 | $14 | $402 | 0.85% |
| DANIEL JAMES PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $219 | — | $219 | 0.46% |
| SHAWN MARIE KING3 | 50 LAGOSHEN DRIVE MOSCOW, TN 38057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | $4 | $66 | 0.14% |
| LVI BENEFITS SERVICES LLC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $1 | $51 | 0.11% |
| BENEFIT ENROLLMENT SERVICES INC3 | 210 CARDEN AVENUE NASHVILLE, TN 37205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.09% |
| BRENDA H BRIDGES3 | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.07% |
| SHEILA A SHELL3 | 413 MOSS TRAIL GOODLETTSVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.07% |
| DENNISE E TRAYWICK3 | 6738 FLAT CREEK RD COLLEGE GROVE, TN 37046 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.05% |
| BRANDI TAFT3 | 7325 AUTUMN CROSSING WAY BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.04% |
| JAMES SHARP3 | 1021 TULIP BLOSSOM DRIVE HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.03% |
| BENEFITS ENRICHED INC3 | 50 LAGOSHEN DRIVE MOSCOW, TN 38057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| EMILY COPELAND3 | PO BOX 453 MIDDLETON, TN 38052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $241 | $142 | $383 | 15.91% |
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 | 91 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 92 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 170 | $499K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 170 | $499K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 170 | $499K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $2K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 54 | $47K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 112 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.