| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM L. GLASS3 | 9053 STONE WALK PLACE GERMANTOWN, TN 38138 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $2K | $55K | $56K | 2.85% |
| COWLEY INSURANCE SERVICES INC3 Filed as: COWLEY INSURANCE SERVICES INC. | 1781 SUMMERLAKE DR TUPELO, MS 38801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20K | $3K | $23K | 15.86% |
| ROBBINS RESEARCH AND PLANNING INC3 Filed as: ROBBINS RESEARCH AND PLANNING INC. | 731 AVIGNON DR. RIDGELAND, MS 39157 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 1.75% |
| JASON RYAN SHEFFIELD3 | 125 MCGRAPH COVE SALTILLO, MS 38866 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $26 | $2K | 1.41% |
| BUCK HALL INS AGY3 | 1420 UNION AVENUE MEMPHIS, TN 38174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | — | $230 | 0.16% |
| MARK CHRISTOPHER HOLLAND3 | P.O. BOX 38366 GERMANTOWN, TN 38138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.04% |
| HAROLD SHAPPELL3 | P.O. BOX 3183 LONGVIEW, TX 75606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.01% |
| DOUGLAS DOSTER3 | P.O. BOX 241449 MEMPHIS, TN 38124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| BSK BENEFITS PLUS LLC3 | 205 PINECREST DR. COVINGTON, LA 70433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| SHELLIE LYN COX3 | 6015 MCCANN RD. LONGVIEW, TX 75605 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| EMILY COPELAND3 | P.O. BOX 453 MIDDLETON, TN 38052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| JAMES CHRISTOPHER TODD3 | 3004 KEYSTONE ST LONGVIEW, TX 75605 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| MPART BENEFITS INC3 | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| ROBERT E HIGDON3 Filed as: ROBERT E. HIGDON | 1016 VENUS DR. LAWRENCEBURG, KY 40342 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| COLONIAL OF NORTH TEXAS INSURANCE3 | 4621 GLEN HEATHER DR FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BETTY C HAYNES3 Filed as: BETTY C. HAYNES | 5513 POPLAR CORNER RD. BROWNSVILLE, TN 38012 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| LINDA R MARCUM3 Filed as: LINDA R. MARCUM | 1147 N. BROAD ST. LEXINGTON, TN 38351 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARKS BENEFIT MANAGEMENT LLC3 | 4257 N GABEL DR FAYETTEVILLE, AR 72703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| WILLIAM L. GLASS3 | 1255 LYNNFIELD ROAD, SUITE A209 MEMPHIS, TN 38119 | DELTA DENTAL OF TENNESSEE | $13K | — | $13K | 10.00% |
| WILLIAM L. GLASS3 | 9053 STONE WALK PLACE GERMANTOWN, TN 38138 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| WILLIAM L. GLASS3 | 9053 STONE WALK PLACE GERMANTOWN, TN 38138 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| WILLIAM L. GLASS3 | 9053 STONE WALK PLACE GERMANTOWN, TN 38138 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $524 | — | $524 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 | Contract Administrator Service code 13 | — | $55K |
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 | 219 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 332 | $2.0M |
| Dental | DELTA DENTAL OF TENNESSEE | 549 | $134K |
| Vision | CIGNA HEALTH & LIFE INSURANCE COMPANY | 332 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 339 | $176K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 140 | $145K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 275 | $177K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 308 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 549 | — |
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.