| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KYLE ARMENY3 | 15800 BRABBS BRANCH WAY, SUITE 350 BROOKEVILLE, MD 20833 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $217K | $0 | $217K | 2.30% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY, INC. | PO BOX 55268 LEXINGTON, KY 40555 | HARTFORD LIFE AND ACCIDENT | $162K | $10K | $172K | 19.00% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY, INC. | 3008 ATKINSON AVENUE LEXINGTON, KY 40509 | DELTA DENTAL OF VIRGINIA | $21K | $0 | $21K | 3.63% |
| ENERGY INSURANCE AGENCY INC4 Filed as: ENERGY INSURANCE AGENCY, INC. | 3008 ATKINSON AVENUE LEXINGTON, KY 40509 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $17K | $0 | $17K | 19.22% |
| ALAN ROMAN4 | 7220 PRINCETON AVENUE SAINT LOUIS, MO 63130 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $120 | $0 | $120 | 0.14% |
| SPETNER ASSOCIATES INC4 Filed as: SPETNER ASSOCIATES, INC. | 8630 DELMAR BOULEVARD, SUITE 100 SAINT LOUIS, MO 63124 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $57 | $0 | $57 | 0.06% |
| JONI M. GROUNDS4 | 6008 WYETH RIDGE ROAD GUNTERSZILLE, AL 35976 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $39 | $0 | $39 | 0.04% |
| ROGER SCHOLL4 | 18612 WEST CAROL AVENUE WADDELL, AZ 85355 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $39 | $0 | $39 | 0.04% |
| RICKEY GOOCH4 | PO BOX 1563 HENDERSONVILLE, TN 37077 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | $0 | $29 | 0.03% |
| ENERGY INSURANCE AGENCY INC3 Filed as: ENERGY INSURANCE AGENCY, INC. | PO BOX 55268 LEXINGTON, KY 40555 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.01% |
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 | 1,116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,592 | $9.4M |
| Dental | DELTA DENTAL OF VIRGINIA | 1,755 | $586K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 429 | $19K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 624 | $906K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 624 | $906K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 624 | $906K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,592 | $9.4M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 624 | $994K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,755 | — |
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.