| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARVA DEVAULT3 | 15305 NORTH DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $25K | — | $25K | 3.02% |
| HALLIE ELDER3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $21K | — | $21K | 2.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC. | 15305 DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 3.30% |
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: CRICHTON, BRANDON, JACKSON & WARD, | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 2.10% |
| CRICHTON BRANDON JACKSON & WARD INC3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $807 | $3K | 12.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC | ATTN TEX RECEIVABLES 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.46% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $692 | $692 | 2.97% |
| CRICHTON BRANDON JACKSON & WARD INC3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $715 | $3K | 12.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC | ATTN TEX RECEIVABLES 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.31% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $612 | $612 | 2.95% |
| CRICHTON BRANDON JACKSON & WARD INC3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $718 | $2K | 11.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC | ATTN TEX RECEIVABLES 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.62% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $615 | $615 | 3.07% |
| CRICHTON BRANDON JACKSON & WARD INC3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $650 | $2K | 12.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC | ATTN TEX RECEIVABLES 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.64% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $557 | $557 | 3.33% |
| CRICHTON BRANDON JACKSON & WARD INC3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $801 | $255 | $1K | 11.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC | ATTN TEX RECEIVABLES 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $616 | — | $616 | 6.52% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $219 | $219 | 2.32% |
| CRICHTON BRANDON JACKSON & WARD INC3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $546 | $181 | $727 | 11.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC | ATTN TEX RECEIVABLES 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $400 | — | $400 | 6.34% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $155 | $155 | 2.46% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $931K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $824K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $824K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $40K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 73 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 53 | $20K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.