| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY WHITE3 Filed as: LARRY S. WHITE | 220 N MAIN STREET STE G-100 DYERSBURG, TN 38024 | BLUECROSS BLUESHIELD | $36K | — | $36K | 7.28% |
| AMY LADD3 Filed as: AMY SERATT | 220 N MAIN STREET STE G-100 DYERSBURG, TN 38024 | BLUECROSS BLUESHIELD | $1K | — | $1K | 0.29% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET, STE G-100 DYERSBURG, TN 38024 | USABLE LIFE - AD&D | $3K | — | $3K | 12.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - AD&D | $3K | — | $3K | 10.00% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET DYERSBURG, TN 38024 | USABLE LIFE - VOLUNTARY INCOME PROTECTION | $3K | — | $3K | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - VOLUNTARY INCOME PROTECTION | $2K | — | $2K | 13.00% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET, STE G-100 DYERSBURG, TN 38024 | USABLE LIFE - VOLUNTARY GROUP TERM LIFE | $2K | — | $2K | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - VOLUNTARY GROUP TERM LIFE | $2K | — | $2K | 13.00% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET SUITE G-100 DYERSBURG, TN 38024 | USABLE LIFE - CANCER | $546 | — | $546 | 5.84% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - CANCER | $459 | — | $459 | 4.91% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET DYERSBURG, TN 38024 | USABLE LIFE - ACCIDENT | $642 | — | $642 | 7.10% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - ACCIDENT | $571 | — | $571 | 6.31% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET, STE G-100 DYERSBURG, TN 38024 | USABLE LIFE - VOLUNTARY AD&D | $297 | — | $297 | 15.01% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - VOLUNTARY AD&D | $257 | — | $257 | 12.99% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET, STE G-100 DYERSBURG, TN 38024 | USABLE LIFE - CRITICAL CARE | $84 | — | $84 | 6.23% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - CRITICAL CARE | $60 | — | $60 | 4.45% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET, STE G-100 DYERSBURG, TN 38024 | USABLE LIFE - HIP | $108 | — | $108 | 17.91% |
| GROPU INSURANCE SERVICES, INC.3 | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - HIP | $89 | — | $89 | 14.76% |
| WHITE & ASSOCIATES3 | 220 N MAIN STREET, STE G-100 DYERSBURG, TN 38024 | USABLE LIFE - TERM LIFE | $15 | — | $15 | 4.81% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE - TERM LIFE | $7 | — | $7 | 2.24% |
| AMY LADD3 Filed as: AMY SERATT | 220 N MAIN ST. G-100 DYERSBURG, TN 38024 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | — | $325 | $325 | — |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD | 133 | $497K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 173 | $0 |
| Vision | BLUECROSS BLUESHIELD | 133 | $497K |
| Life insurance(3 contracts, 3 carriers) | USABLE LIFE - AD&D | 143 | $42K |
| Short-term disability(3 contracts, 3 carriers) | USABLE LIFE - AD&D | 143 | $38K |
| Other(3 contracts, 3 carriers) | USABLE LIFE - CANCER | 28 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.