| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRENT WICK3 | 246 E 11TH ST STE 302 CHATTANOOGA, TN 37402 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $70K | $0 | $70K | 14.40% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 4.36% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 3.55% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 14.97% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $243 | $5K | 15.75% |
| EVERGREEN MANAGEMENT INC3 Filed as: EVERGREEN CONSULTING INC | 1200 PREMIER DR STE 210 CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $218 | $3K | 9.01% |
| EVERGREEN MANAGEMENT INC3 Filed as: EVERGREEN CONSULTING INC | 1200 PREMIER DR STE 210 CHATTANOOGA, TN 37421 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $2K | $10K | 58.46% |
| M FINANCIAL HOLDINGS INC3 | STE 900 1125 NW COUCH ST PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $720 | $720 | 4.07% |
| RUSS BLAKELY & ASSOCIATES LLC3 Filed as: RUSS BLAKELY & ASSOCIATES, LLC | 246 EAST 11TH STREET SUITE 302 CHATTANOOGA, TN 37402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $740 | $2K | 14.96% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 UNION SQ STE 303 CHATTANOOGA, TN 37402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $358 | $0 | $358 | 3.14% |
| THE DYER AGENCY3 | PO BOX 4160 CHATTANOOGA, TN 37405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $122 | $0 | $122 | 1.07% |
| THE DYER AGENCY3 Filed as: DYER, DOUGLAS M | PO BOX 4160 CHATTANOOGA, TN 37405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $68 | $0 | $68 | 0.60% |
| MARSH & MCLENNAN AGENCY LLC3 | P O BOX 70 WEST POINT, GA 31833 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $11 | $11 | 0.10% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 UNION SQ STE 303 CHATTANOOGA, TN 37402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $398 | $0 | $398 | 4.91% |
| THE DYER AGENCY3 | PO BOX 4160 CHATTANOOGA, TN 37405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $157 | $0 | $157 | 1.94% |
| OEHMIG, WILLIAM, BRIT | PO BOX 2587 CHATTANOOGA, TN 37409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $308 | $0 | $308 | 9.99% |
| JACK B TURNER3 Filed as: JACK B TURNER & ASSOCIATES INC | PO BOX 627 CLARKSVILLE, TN 37041 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $0 | $123 | 3.99% |
| MGIS3 Filed as: MGIS, INC. | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $47 | $60 | $107 | 5.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: DAVIS SMITH & BROWN INC | 6025 LEE HWY, SUITE 316 CHATTANOOGA, TN 37421 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 1.36% |
| RUSS BLAKELY & ASSOCIATES LLC3 Filed as: RUSS BLAKELY & ASSOCIATES | PO BOX 11310 CHATTANOOGA, TN 37401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $143 | $0 | $143 | 15.05% |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 304 | $489K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 304 | $489K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 82 | $15K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 196 | $184K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 36 | $41K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 183 | $157K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 259 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.