| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 741738 ATLANTA, GA 303741738 | HARTFORD LIFE AND ACCIDENT | $24K | — | $24K | 1.72% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 3 CITYPLACE DR STE 900 ST LOUIS, MO 63141 | HM LIFE INSURANCE COMPANY | $39K | — | $39K | 5.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 1715 AARON BRENNER DR SUITE 512 MEMPHIS, TN 38120 | HARTFORD LIFE AND ACCIDENT | $13K | $1K | $14K | 16.66% |
| CYNTHIA HALL3 | 2225 LEEVILLE PIKE LEBANON, TN 37090 | AFLAC | $164 | — | $164 | 3.66% |
| PAYLOGIX3 | 1025 OLD COUNTRY RD SUITE 310 WESTBURY, NY 11590 | AFLAC | $91 | — | $91 | 2.03% |
| GARY W LOVELL3 Filed as: GARY LOVELL | PO BOX 90866 NASHVILLE, TN 37209 | AFLAC | $74 | — | $74 | 1.65% |
| KIMMETTE WHITENER3 | 1380 WHISPERING OAKS DR LEBANON, TN 37090 | AFLAC | $64 | — | $64 | 1.43% |
| WILSON BANK & TRUST3 | PO BOX 768 LEBANON, TN 37088 | AFLAC | $54 | — | $54 | 1.21% |
| DAVID B RAY3 Filed as: DAVID RAY | 5122 STONEWOOD DR SMYRNA, TN 37167 | AFLAC | $48 | — | $48 | 1.07% |
| RICK R THORNE3 Filed as: RICK THORNE | 321 W MAIN ST LEBANON, TN 37087 | AFLAC | $31 | — | $31 | 0.69% |
| RONALD H RICHEY3 Filed as: RONALD RICHEY | 4499 MURFREESBORO RD FRANKLIN, TN 37067 | AFLAC | $20 | — | $20 | 0.45% |
| JAMES C FARMER JR3 Filed as: JAMES FARMER JR | 261 CRIMSON SKY CT DRIPPING SPRINGS, TX 78620 | AFLAC | $10 | — | $10 | 0.22% |
| ABBIE W COFFMAN3 Filed as: ABBIE COFFMAN | 31 HAWTHORN CIRCLE CROSSVILLE, TN 38555 | AFLAC | $9 | — | $9 | 0.20% |
| KANDI H HECKLER3 Filed as: KANDI HECKLER | 5453 HASELL DR ROCKVALE, TN 37153 | AFLAC | $3 | — | $3 | 0.07% |
| AUTUMN BETHEA3 | 1124 GOLF VIEW WAY SPRING HILL, TN 37174 | AFLAC | $1 | — | $1 | 0.02% |
| MCGRIFF INSURANCE SERVICES INC3 | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 2.08% |
| SHARON MAY LINDSAY3 | 724 WILDFLOWER LN CHATTANOOGA, TN 37419 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 1.69% |
| KATHERINE C ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37363 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.65% |
| THE ADAMSON GROUP INC3 | 344 SUMMERSET DR CHAPIN, SC 29036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.52% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II INC | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.39% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCIENNAN AGENCY LLC | 7701 AIRPORT CENTER DR GREENSBORO, NC 27409 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.39% |
| INSYNC BENEFITS INC3 | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.26% |
| MAX MARTIN LINDSAY3 | 724 WILDFLOWER LN CHATTANOOGA, TN 37419 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $918K |
| HEALTHEQUITY EIN 52-2383166 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $18K |
| TENNESSEE FARMERS COOPERATIVE EIN 62-0435104 PLAN SPONSOR | Other fees; Plan Administrator Service code 14 | — | $8K |
| REGIONS BANK CUSTODIAN | Custodial (securities) Service code 19 | 315 DEADERICK ST - 3RD FL NASHVILLE, TN 37238 | $3K |
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 | 1,674 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,702 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 3,160 | $0 |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,472 | $523K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,472 | $523K |
| Life insurance(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 1,695 | $1.4M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,695 | $1.4M |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 1,616 | $786K |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 3,415 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,415 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.