| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRADSHAW & COMPANY3 | 421 WEST COURT STREET DYERSBURG, TN 38024 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $167K | — | $167K | 1.64% |
| BRADSHAW & COMPANY3 | 425 WEST COURT STREET DYERSBURG, TN 38024 | GUARDIAN | $42K | — | $42K | 10.00% |
| BRADSHAW & COMPANY3 | 421 WEST COURT STREET DYERSBURG, TN 38024 | USABLE LIFE | $23K | — | $23K | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $20K | — | $20K | 13.00% |
| YOUR BENEFITS AGENCY INC3 Filed as: YOUR BENEFITS AGENCY | 17500 CHENAL PARKWAY, SUITE 150 LITTLE ROCK, AR 72223 | USABLE LIFE | $252 | — | $252 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH TECH AFFILIATES EIN 62-1278576 ADMIN EAP PLAN | Consulting (general); Participant communication; Direct payment from the plan; Contract Administrator; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | 350 N HUMPREYS BLVD MEMPHIS, TN 38120 | $14K |
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 | 1,147 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,578 | $10.2M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,578 | $10.2M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,578 | $10.2M |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 1,141 | $573K |
| Short-term disability | GUARDIAN | 1,002 | $420K |
| Long-term disability | NATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION | 979 | $584K |
| Other(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,578 | $10.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,578 | — |
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.