| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WESLEY BROWN | PO BOX 305025 NASHVILLE, TN 37230 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $41K | — | $41K | 4.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | PO BOX 305025 NASHVILLE, TN 37230 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 7.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $544 | — | $544 | 1.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | PO BOX 305025 NASHVILLE, TN 37230 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $429 | — | $429 | 1.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC. | PO BOX 305025 NASHVILLE, TN 37230 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 7.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $522 | — | $522 | 2.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE | PO BOX 305025 NASHVILLE, TN 37230 | EYEMED VISION CARE | $2K | — | $2K | 12.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | PO BOX 305025 NASHVILLE, TN 37230 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 19.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $134 | — | $134 | 1.69% |
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 | 270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 297 | $947K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 297 | $947K |
| Vision | EYEMED VISION CARE | 262 | $14K |
| Life insurance | STANDARD INSURANCE COMPANY | 199 | $29K |
| Short-term disability | STANDARD INSURANCE COMPANY | 71 | $36K |
| Long-term disability(2 contracts) | STANDARD INSURANCE COMPANY | 54 | $29K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 297 | $947K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 297 | — |
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.