| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHEILA GURIEN3 | 220 N MAIN STREET DYERSBURG, TN 38024 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $41K | — | $41K | 1.73% |
| WHITE & ASSOCIATES3 Filed as: WHITE & ASSOCIATES INSURANCE AGENCY | 220 N MAIN STREET SUITE G-100 DYERSBURG, TN 38024 | USABLE LIFE | $42K | — | $42K | 19.54% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $23K | — | $23K | 10.61% |
| WHITE & ASSOCIATES3 Filed as: WHITE & ASSOCIATES INSURANCE AGENCY | 220 N MAIN STREET SUITE G-100 DYERSBURG, TN 38024 | USABLE LIFE | $9K | — | $9K | 13.66% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $5K | — | $5K | 8.08% |
| WHITE & ASSOCIATES3 Filed as: WHITE & ASSOCIATES INSURANCE | 220 N MAIN STREET DYERSBURG, TN 38024 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 19.99% |
| WHITE & ASSOCIATES3 Filed as: WHITE & ASSOCIATES INSURANCE | 220 N MAIN STREET DYERSBURG, TN 38024 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $117 | — | $117 | 19.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CARRIER | Contract Administrator Service code 13 | — | $179K |
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 | 278 | 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) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 450 | $2.4M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 450 | $2.4M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 450 | $2.4M |
| Life insurance(2 contracts) | USABLE LIFE | 259 | $279K |
| Short-term disability | USABLE LIFE | 259 | $213K |
| Long-term disability(2 contracts) | USABLE LIFE | 259 | $279K |
| Other(4 contracts, 2 carriers) | USABLE LIFE | 259 | $287K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 450 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.