| 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. | $37K | — | $37K | 3.73% |
| 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 | 4.35% |
| BENEFIT ENROLLMENT SERVICES INC3 Filed as: BENEFIT ENROLLMENT SRVICES, INC. | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE & ACCIDENT INSURANCE | $875 | — | $875 | 2.46% |
| TONYA BELL3 | 3228 CLAPHAM ROAD ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE | $527 | — | $527 | 1.48% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH S. GOLDEN | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $450 | — | $450 | 1.26% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $429 | — | $429 | 1.20% |
| SUSAN MAE DANIEL3 | 205 MORNINGSIDE DRIVE HOPKINSVILLE, KY 42240 | COLONIAL LIFE & ACCIDENT INSURANCE | $282 | — | $282 | 0.79% |
| DENNIS E TRAYWICK3 Filed as: DENNIS E. TRAYWICK | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE & ACCIDENT INSURANCE | $238 | — | $238 | 0.67% |
| ANIMAL EMPIRE INC3 Filed as: ANIMAL EMPIRE INC. | 1024 GRANADA AVE NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE | $175 | — | $175 | 0.49% |
| DEBBIE PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE | $55 | — | $55 | 0.15% |
| VIOLET P COOTS3 Filed as: VIOLET P. COOTS | 1870 PLANO RICHPOND ROAD BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE | $24 | — | $24 | 0.07% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE | $21 | — | $21 | 0.06% |
| JERILYN H HIPPLER3 Filed as: JERILYN H. HIPPLER | 1219 AUTUMN OAKS DRIVE FRANKLIN, KY 42134 | COLONIAL LIFE & ACCIDENT INSURANCE | $1 | — | $1 | 0.00% |
| HOUCHENS INSURANCE GROUP INC3 Filed as: HOUCHENS INSURANCE GROUP, INC. | 109 INTERNATIONAL DRIVE SUITE 101 FRANKLIN, TN 37067 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 21.44% |
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 | 166 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 166 | 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."
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.