No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Actuarial; Consulting (general); Plan Administrator Service code 11 | P.O. BOX 1449 GOODLETTSVILLE, TN 37070 | $132K |
| CIGNA HEALTHCARE EIN 06-0303370 NONE | Named fiduciary; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | 1111 MARKET ST CHATTANOOGA, TN 37402 | $70K |
| ANTHEM BLUE CROSS BLUE SHIELD EIN 54-0357120 NONE | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Claims processing; Contract Administrator Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | $35K |
| DANIELS, IRWIN & AYLOR EIN 62-1802605 NONE | Accounting (including auditing) Service code 10 | 223 MADISON ST. STE 112 MADISON, TN 37115 | $9K |
| SUNTRUST BANK NONE | Custodial (other than securities) Service code 18 | P.O. BOX 305183 NASHVILLE, TN 372305183 | $5K |
| MUTUAL & EXCHANGE TRADED FUNDS NONE | Custodial (securities); Investment management Service code 19 | — | $0 |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 69 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL LIFE INSURANCE COMPANY | 263 | $37K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 263 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.