| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH PAYLOR3 Filed as: KENNETH D PAYLOR | 5100 POPLAR AVENUE, SUITE 1200 MEMPHIS, TN 38137 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $64K | — | $64K | 4.38% |
| BRANDON STAHL3 | 606 S MENDENHALL SUITE 200 MEMPHIS, TN 38117 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $17K | — | $17K | 1.19% |
| WILLIAM T. TYSON3 | PO BOX 770053 MEMPHIS, NE 38177 | DELTA DENTAL OF TENNESSEE | $3K | — | $3K | 3.75% |
| ZOE ANDERSON3 | 11989 CAMPBELL ARLINGTON, TN 38002 | DELTA DENTAL OF TENNESSEE | $3K | — | $3K | 3.75% |
| WILLIAM T. TYSON3 | PO BOX 770053 MEMPHIS, NE 38177 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 31.29% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 18.73% |
| JAS D COLLIER & CO3 Filed as: JAS D. COLLIER & CO | 606 S MENDENHALL SUITE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $490 | — | $490 | 2.26% |
| USI INSURANCE SERVICES LLC3 | 5100 POPLAR AVENUE, SUITE 1200 MEMPHIS, TN 38137 | VISION SERVICE PLAN | $255 | — | $255 | 1.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 18.94% |
| JAS D COLLIER & CO3 Filed as: JAS D. COLLIER & CO | 606 S MENDENHALL SUITE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $437 | — | $437 | 2.31% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $923 | $773 | $2K | 15.68% |
| JAS D COLLIER & CO3 Filed as: JAS D. COLLIER & CO | 606 S MENDENHALL SUITE 200 MEMPHIS, TN 38117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $159 | — | $159 | 1.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC. EIN 04-2734278 THIRD PARTY ADMINISTRATO | Claims processing; Other services Service code 12 | — | $23K |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 213 | $1.5M |
| Dental | DELTA DENTAL OF TENNESSEE | 222 | $71K |
| Vision | VISION SERVICE PLAN | 116 | $21K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $19K |
| Long-term disability | STANDARD INSURANCE COMPANY | 70 | $23K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 213 | $1.5M |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.