| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 1125 SANCTUARY PARKWAY STE 300 ALPHARETTA, GA 30009 | HARTFORD LIFE AND ACCIDENT | $53K | — | $53K | 14.67% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 701 B STREET 6TH FLR SAN DIEGO, CA 92101 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 1.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | -$5 | -$5 | -0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES LLC | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | — | $6K | 9.18% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES LLC | 5444 WESTHEIMER RD #900 HOUSTON, TX 77056 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $983 | — | $983 | 1.62% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES LLC | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES LLC | 5444 WESTHEIMER RD #900 HOUSTON, TX 77056 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $262 | — | $262 | 1.72% |
| ALLIANT INSURANCE SERVICES, INC.3 | 4870 SADLER RD STE 300 GLEN ALLEN, VA 230606294 | CONTINENTAL AMERICAN INSURANCE COMPANY | $299 | — | $299 | 5.52% |
| CHRISTOPHER G RICHARDSON3 | 1011 NORFOLK GREEN CIRCLE CHATANOOGA, TN 37421 | CONTINENTAL AMERICAN INSURANCE COMPANY | $110 | — | $110 | 2.03% |
| HEYWARD RICHARDSON JR3 Filed as: HEYWARD RICHARDSON | 1163 MCCORDS FERRY RD LUGOFF, SC 29078 | CONTINENTAL AMERICAN INSURANCE COMPANY | $74 | — | $74 | 1.37% |
| HAROLD S CANDLER3 | 1363 HEADQUARTERS PLANTATION D JOHN ISLAND, SC 29455 | CONTINENTAL AMERICAN INSURANCE COMPANY | $44 | — | $44 | 0.81% |
| ELIZABETH E REEVES3 | 1200 MOUNTAIN CREEK RD #102 CHATTANOOGA, TN 37405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $38 | — | $38 | 0.70% |
| LINDA F LEE3 | 2120 HAVEN CREST CHATTANOOGA, TN 37421 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | — | $30 | 0.55% |
| CHARLES F GREER3 | 9537 PECKY CYPRESS WAY ORLANDO, FL 32836 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.52% |
| ANDREW F VERBOSKY JR3 Filed as: ANDREW F VERBOSKY, JR. | 491 QUARRY LN WARREN, OH 44483 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25 | — | $25 | 0.46% |
| DANIEL MATHIS3 | 1200 MTN CREEK RD STE 102 CHATTANOOGA, TN 37405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.44% |
| JOSHUA R MARTIN3 | 307 SCENIC DRIVE TUNNEL HILL, GA 30755 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.44% |
| PAULA J FAMBROUGH3 | 8205 DUNMORE DRIVE APT C HUNTERSVILLE, NC 28078 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | — | $21 | 0.39% |
| LEWIS P AGNONE3 | 360 EASTWOOD DR HUBBARD, OH 44425 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | — | $19 | 0.35% |
| BRENT L GOODE3 | 2000 GLEN ECHO RD SUITE 204 NASHVILLE, TN 37215 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.33% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.22% |
| KRISTY K COUSINS3 | 315 WALSH ROAD CHATTANOOGA, TN 37405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.17% |
| TJH CONSULTANTS LLC3 | 2720 BRIARWOOD CT POLAND, OH 44514 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.15% |
| AUSTIN T RADER3 | 242 HERITAGE PARK DR STE 106 MURFREESBORO, TN 37129 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.13% |
| JAMES SMITH3 Filed as: JAMES B SMITH | 100 W CYPRESS ROAD STE 630 FT LAUDERDALE, FL 33309 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.13% |
| TERRANCE M LUCZAJ3 | 435 HARRODS LANE CHARLESTON, SC 29412 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.07% |
| JOSEPH L LEDOUX3 | 674 WATSON BRANCH DRIVE FRANKLIN, TN 37064 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.07% |
| JACKSON D RHODES3 | 2332 VOLUNTEER PKWY BRISTOL, TN 37620 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.06% |
| DAVID CLAYTON3 | 1054 CARTER DRIVE CHATTANOOGA, TN 37415 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.04% |
| DAYTON LLC3 | 221 SERENITY DR PICKENS, SC 29671 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.04% |
| JAY S OLEARY3 Filed as: JAY S O'LEARY | 301 MALLORY STATION RD STE. 100 FRANKLIN, TN 37067 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.04% |
| GARY W JOHNSON3 | 123 CENTER PARK DRIVE SUITE 123 KNOXVILLE, TN 37922 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| JACK A SHADE3 | 470 OLDE WORTHIN GTON RD STE 250 WESTERVILLE, OH 43082 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| SHARON MAY LINDSAY3 Filed as: SHARON B SESSOMS | 1431 ONEAL RD HIXSON, TN 37343 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS COMPANY EIN 59-1031071 CLAIMS PROCESSING | Claims processing; Float revenue; Non-monetary compensation; Contract Administrator; Participant communication; Named fiduciary; Other services; Direct payment from the plan Service code 12 | — | $327K |
| ALLIANT INS SERVICES INC CLAIMS PROCESSING | Claims processing Service code 12 | PASADENA CA PO BOX 8299 PASADENA, CA 91109 | $69K |
| BLUECROSS BLUESHIELD OF ST CAROLINA EIN 57-0287419 CLAIMS PROCESSING | Claims processing Service code 12 | — | $28K |
| CIGNA | Named fiduciary; Participant communication; Claims processing; Float revenue; Contract Administrator; Other services; Non-monetary compensation; Direct payment from the plan Service code 12 | — | $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 | 745 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 776 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 568 | $76K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 544 | $365K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 544 | $360K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 544 | $365K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 568 | — |
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.