| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 0.76% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 0.67% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HM LIFE INSURANCE COMPANY | $13K | — | $13K | 4.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $11K | $417 | $12K | 15.54% |
| BROWNIE D HALL3 | 321 W MAIN ST LEBANON, TN 37087 | AFLAC | $796 | — | $796 | 3.30% |
| PAYLOGIX3 | 1025 OLD COUNTRY ROAD SUITE 310 WESTBURY, NY 11590 | AFLAC | $415 | — | $415 | 1.72% |
| GARY W LOVELL3 | PO BOX 682146 FRANKLIN, TN 37068 | AFLAC | $389 | — | $389 | 1.61% |
| WILSON BANK & TRUST3 | 623 WEST MAIN ST LEBANON, TN 37087 | AFLAC | $310 | — | $310 | 1.29% |
| RICHARD R WHITENER3 | 1104 SOMERSET DR LEBANON, TN 37090 | AFLAC | $301 | — | $301 | 1.25% |
| RICK R THORNE3 | 321 W MAIN ST LEBANON, TN 37087 | AFLAC | $253 | — | $253 | 1.05% |
| DAVID B RAY3 | 5122 STONEWOOD DR SMYRNA, TN 37167 | AFLAC | $187 | — | $187 | 0.78% |
| RONALD H RICHEY3 | 4023 LAURAWOOD LANE FRANKLIN, TN 37064 | AFLAC | $117 | — | $117 | 0.49% |
| W REID PATTON3 | PO BOX 218 SEWANEE, TN 37375 | AFLAC | $56 | — | $56 | 0.23% |
| CARL BUTLER RAGLAND JR3 | 1705 HOLLOW OAK DRIVE LEBANON, TN 37087 | AFLAC | $49 | — | $49 | 0.20% |
| ABBIE W COFFMAN3 | 31 HAWTHORN CIRCLE CROSSVILLE, TN 38555 | AFLAC | $44 | — | $44 | 0.18% |
| JAMES C FARMER JR3 | 641 OLD HICKORY BLVD UNIT 6D BRENTWOOD, TN 37027 | AFLAC | $33 | — | $33 | 0.14% |
| JANE E TUCKER3 | PO BOX 2825 SHELBYVILLE, TN 37162 | AFLAC | $33 | — | $33 | 0.14% |
| LESLIE H SILTMAN3 | 207 MOORE DRIVE BATESVILLE, MS 38606 | AFLAC | $29 | — | $29 | 0.12% |
| WAYNE E BURTON3 | 433 SOUTH PLANTATION DRIVE COOKEVILLE, TN 38506 | AFLAC | $23 | — | $23 | 0.10% |
| WILLIAM D HEYDEL3 | 524 CROWELL LANE LEBANON, TN 37087 | AFLAC | $14 | — | $14 | 0.06% |
| PHYLLIS DAWN HESLEP3 Filed as: PHYLLIS S BRALY | PO BOX 327 PULASKI, TN 38478 | AFLAC | $11 | — | $11 | 0.05% |
| WHITWELL & ASSOCIATES INC3 | 702 DOW DRIVE SHELBYVILLE, TN 37160 | AFLAC | $10 | — | $10 | 0.04% |
| JOHN H SEWELL3 | 1933 SHENANDOAH TRAIL LEBANON, TN 37087 | AFLAC | $9 | — | $9 | 0.04% |
| RONALD A DASHKOVITZ3 | 20 MILLPOND TRAIL SAGINAW, MI 48603 | AFLAC | $7 | — | $7 | 0.03% |
| RICHARD D HEYDEL3 | 1921 OLD HICKORY BLVD BRENTWOOD, TN 37027 | AFLAC | $2 | — | $2 | 0.01% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $263 | — | $263 | 2.64% |
| SHARON MAY LINDSAY3 | 2911 STAGE RUN DRIVE HIXON, TN 37343 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $214 | — | $214 | 2.15% |
| KATHERINE C ROBERTS3 | 8846 PICADILLY TRAIL OOLTEWAH, TN 37363 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | — | $114 | 1.14% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II INC | 248 RIVERWOOD DR LEWISVILLE, NC 27023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.49% |
| THE ADAMSON GROUP INC3 | 344 SUMMERSET DR CHAPIN, SC 29036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.46% |
| INSYNC BENEFITS INC3 | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.30% |
| MAX MARTIN LINDSAY3 | 2911 STAGE RUN DRIVE HIXON, TN 37343 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.15% |
| ADVANCED BENEFIT SYSTEM INC3 | 1301 GERVAIS STREET COLUMBIA, SC 29201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.03% |
| J W RAINEY INC3 | 2900 VANDERBILT PLACE NASHVILLE, TN 37212 | THE CANADA LIFE ASSURANCE COMPANY | $282 | — | $282 | 11.12% |
| THW INSURANCE SERVICES LLC3 | 321 WEST MAIN STREET LEBANON, TN 37087 | PENN TREATY NETWORK AMERICA INSURANCE COMPANY | $42 | — | $42 | 10.07% |
| M&O MARKETING INC3 | 4000 TOWN CENTER SUITE 11 SOUTHFIELD, MI 480751401 | PENN TREATY NETWORK AMERICA INSURANCE COMPANY | $10 | — | $10 | 2.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.2M |
| HEALTHEQUITY EIN 52-2383166 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $28K |
| WEAVER C BARKSDALE & ASSOCIATES INC INVESTMENT MANAGER | Investment management Service code 28 | ONE BURTON HILLS BLVD SUITE 100 NASHVILLE, TN 37215 | $20K |
| REGIONS BANK CUSTODIAN | Custodial (securities) Service code 19 | 315 DEADERICK ST - 3RD FL NASHVILLE, TN 37238 | $6K |
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 | 2,118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 4,259 | $0 |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,534 | $493K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 2,534 | $493K |
| Life insurance(6 contracts, 6 carriers) | HARTFORD LIFE AND ACCIDENT | 2,156 | $1.0M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,156 | $966K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 2,081 | $323K |
| Other(5 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 2,150 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,259 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.