| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEIKO BURKHALTER3 | 3560 LENOX RD STE 2400 ATLANTA, GA 30326 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $57K | $0 | $57K | 2.19% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $18K | $0 | $18K | 7.83% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC | 1166 AVENUE OF THE AMERICAS PO BOX 28198 NEW YORK, NY 10087 | USABLE LIFE | $3K | $0 | $3K | 1.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS | PO BOX 9465 NEW YORK, NY 10087 | DELTA DENTAL OF TENNESSEE | $4K | $0 | $4K | 4.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | PO BOX 28031 NEW YORK, NY 10087 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.60% |
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 | 218 | 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) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 362 | $2.6M |
| Dental | DELTA DENTAL OF TENNESSEE | 328 | $112K |
| Vision | VISION SERVICE PLAN | 167 | $24K |
| Life insurance | USABLE LIFE | 229 | $230K |
| Short-term disability | USABLE LIFE | 229 | $230K |
| Long-term disability | USABLE LIFE | 229 | $230K |
| Other | USABLE LIFE | 229 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.