| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRENT WICK3 | 4823 OLD KINGSTON PK STE 300 KNOXVILLE, TN 37919 | BLUECROSS BLUESHIED OF TENNESSEE, INC. | $68K | $0 | $68K | 13.96% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 3.52% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $1K | $7K | 4.46% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $253 | $5K | 15.75% |
| EVERGREEN MANAGEMENT INC3 | 1400 WILLIAMS ST CHATTANOOGA, TN 37408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 13.96% |
| EVERGREEN MANAGEMENT INC3 Filed as: EVERGREEN CONSULTING INC | 1200 PREMIER DRIVE STE 210 CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $199 | $2K | 9.35% |
| EVERGREEN MANAGEMENT INC3 Filed as: EVERGREEN CONSULTING INC | 1200 PREMIER DRIVE STE 210 CHATTANOOGA, TN 37421 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 8.66% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $356 | $356 | 1.98% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PARTNERS LL | 246 EAST 11TH STREET SUITE 302 CHATTANOOGA, TN 37402 | GUARDIAN | $2K | $1K | $3K | 18.25% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 UNION SQ STE 303 CHATTANOOGA, TN 37402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $277 | $0 | $277 | 2.85% |
| THE DYER AGENCY3 | PO BOX 4160 CHATTANOOGA, TN 37405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $99 | $0 | $99 | 1.02% |
| DOUGLAS DYER3 | PO BOX 4160 CHATTANOOGA, TN 37405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $58 | $0 | $58 | 0.60% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $8 | $8 | 0.08% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 UNION SQ STE 303 CHATTANOOGA, TN 37402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $424 | $0 | $424 | 5.34% |
| THE DYER AGENCY3 | PO BOX 4160 CHATTANOOGA, TN 37405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $131 | $0 | $131 | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $6 | $6 | 0.08% |
| OEHMIG, WILLIAM, BRIT3 | 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 | $44 | $60 | $104 | 5.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: DAVIS SMITH & BROWN INC | SUITE 104 7213 NOAH REID ROAD CHATTANOOGA, TN 37421 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 1.20% |
| 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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIED OF TENNESSEE, INC. | 300 | $488K |
| Dental | BLUECROSS BLUESHIED OF TENNESSEE, INC. | 300 | $488K |
| Vision | GUARDIAN | 100 | $16K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $187K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 33 | $36K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 168 | $152K |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 245 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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.