| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RH GROUP SERVICES INC3 Filed as: RH GROUP SERVICES, INC. | P.O. BOX 1801 COLUMBIA, TN 384021801 | HCC LIFE INSURANCE COMPANY | $26K | — | $26K | 11.91% |
| RH GROUP SERVICES INC3 Filed as: RH GROUP SERVICES, INC. | P.O. BOX 1801 COLUMBIA, TN 384021801 | VISION SERVICE PLAN | $2K | — | $2K | 13.00% |
| TENNESSEE RURAL HEALTH3 | 147 BEAR CREEK PIKE COLUMBIA, TN 38401 | BLUE CROSS & BLUE SHIELD OF TENNESSEE | $1K | $6 | $1K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Claims processing; Direct payment from the plan; Float revenue; Other fees Service code 12 | — | $387K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $111K |
| TN RURAL HEALTH BROKER | Contract Administrator Service code 13 | P.O. BOX 1801 COLUMBIA, TN 384021801 | $30K |
| RH GROUP SERVICES, INC. EIN 62-1555696 BROKER | Other commissions Service code 55 | — | $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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 26 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF TENNESSEE | 234 | $0 |
| Vision | VISION SERVICE PLAN | 112 | $12K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 207 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.