| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY L MCCLURE3 Filed as: GARY MCCLURE | 1240 FAIRWAY STREET BOWLING GREEN, KY 42103 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $56K | — | $56K | 5.54% |
| CHRISTOPHER SIMMONS3 Filed as: CHRISTOPHER H. SIMMONS | 109 INTERNATIONAL DRIVE STE 101 FRANKLIN, TN 37067 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $3K | — | $3K | 0.28% |
| VMI ACQUISITION INC3 Filed as: VMI ACQUISITION, INC. | PO BOX 1779 BOWLING GREEN, KY 42102 | COLONIAL LIFE & ACCIDENT INSURANCE | $2K | — | $2K | 4.88% |
| AMY B CITRON3 Filed as: AMY C. WOLFE | 1024 GRANADA AVE NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE | $1K | — | $1K | 2.96% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $626 | — | $626 | 1.75% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH S. GOLDEN | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $564 | — | $564 | 1.57% |
| BENEFIT ENROLLMENT SERVICES INC3 Filed as: BENEFIT ENROLLMENT SRVICES, INC. | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE & ACCIDENT INSURANCE | $458 | — | $458 | 1.28% |
| SUSAN MAE DANIEL3 | 363 PLEASANT PLACE WAY BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $419 | — | $419 | 1.17% |
| DENNIS E TRAYWICK3 Filed as: DENNIS E. TRAYWICK | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE & ACCIDENT INSURANCE | $271 | — | $271 | 0.76% |
| ANIMAL EMPIRE INC3 Filed as: ANIMAL EMPIRE INC. | 1024 GRANADA AVE NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE | $149 | — | $149 | 0.42% |
| VIOLET P COOTS3 Filed as: VIOLET P. COOTS | 1870 PLANO RICHPOND ROAD BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $59 | — | $59 | 0.16% |
| DEBBIE PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE | $51 | — | $51 | 0.14% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE | $29 | — | $29 | 0.08% |
| JERILYN H HIPPLER3 Filed as: JERILYN H. HIPPLER | 1219 AUTUMN OAKS DRIVE FRANKLIN, KY 42134 | COLONIAL LIFE & ACCIDENT INSURANCE | $5 | — | $5 | 0.01% |
| VAN METER INSURANCE AGENCY INC3 Filed as: VAN METER INSURANCE AGENCY, INC. | 109 INTERNATIONAL DRIVE SUITE 101 FRANKLIN, TN 37067 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 18.18% |
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 | 180 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.