| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRADSHAW & COMPANY3 | 421 WEST COURT STREET DYERSBURG, TN 38024 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $279K | — | $279K | 1.87% |
| BRADSHAW & COMPANY3 | 421 W COURT STREET DYERSBURG, TN 38024 | SYMETRA | $79K | — | $79K | 7.98% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | SYMETRA | $10K | — | $10K | 0.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH TECH AFFILIATES EIN 62-1278576 ADMIN EAP PLAN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Participant communication; Consulting (general); Plan Administrator Service code 13 | 350 N HUMPREYS BLVD MEMPHIS, TN 38120 | $10K |
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 | 1,367 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 3,065 | $14.9M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 3,065 | $14.9M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 3,065 | $14.9M |
| Life insurance | SYMETRA | 1,246 | $987K |
| Short-term disability | SYMETRA | 1,246 | $987K |
| Long-term disability | NATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION | 1,224 | $852K |
| Other(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 3,065 | $15.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,065 | — |
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.