| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUSS BLAKELY & ASSOCIATES LLC3 Filed as: RUSS BLAKELY | 4211 W. BOY SCOUT BLVD SUITE 800 TAMPA, FL 33607 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $63K | $0 | $63K | 12.68% |
| BRENT WICK3 | 246 E 11TH ST STE 302 CHATTANOOGA, TN 37402 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $6K | $0 | $6K | 1.23% |
| EVERGREEN MANAGEMENT INC3 | 6756 EXECUTIVE OAK LN CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 3.39% |
| EVERGREEN MANAGEMENT INC3 | 6756 EXECUTIVE OAK LN CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 4.26% |
| EVERGREEN MANAGEMENT INC3 | 6756 EXECUTIVE OAK LN CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 14.86% |
| EVERGREEN MANAGEMENT INC3 | 6756 EXECUTIVE OAK LN CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $231 | $5K | 15.75% |
| EVERGREEN MANAGEMENT INC3 Filed as: EVERGREEN CONSULTING INC | 6756 EXECUTIVE OAK LN CHATTANOOGA, TN 37421 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $195 | $2K | 9.41% |
| EVERGREEN MANAGEMENT INC3 Filed as: EVERGREEN CONSULTING INC | 6756 EXECUTIVE OAK LN CHATTANOOGA, TN 37421 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $115 | $2K | 11.21% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $408 | $408 | 2.13% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PARTNERS LL | 246 EAST 11TH STREET SUITE 302 CHATTANOOGA, TN 37402 | GUARDIAN | $2K | $960 | $3K | 15.23% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 UNION SQ STE 303 CHATTANOOGA, TN 37402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $225 | $0 | $225 | 2.56% |
| THE DYER AGENCY3 | PO BOX 4160 CHATTANOOGA, TN 37405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $80 | $0 | $80 | 0.91% |
| THE DYER AGENCY3 Filed as: DYER, DOUGLAS, M | PO BOX 4160 CHATTANOOGA, TN 37405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.58% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2 | $2 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 UNION SQ STE 303 CHATTANOOGA, TN 37402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $324 | $0 | $324 | 4.97% |
| THE DYER AGENCY3 | PO BOX 4160 CHATTANOOGA, TN 37405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $115 | $0 | $115 | 1.76% |
| OEHMIG, WILLIAM, BRIT3 | PO BOX 2587 CHATTANOOGA, TN 37409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $263 | $0 | $263 | 10.01% |
| JACK B TURNER3 Filed as: JACK B TURNER & ASSOCIATES INC | PO BOX 627 CLARKSVILLE, TN 37041 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $0 | $105 | 4.00% |
| 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 | $30 | $0 | $30 | 1.22% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 Filed as: BALDWIN KRYSTYN SHERMAN PARTNERS LL | 4211 W. BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $143 | $29 | $172 | 18.11% |
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 | 178 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 299 | $494K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 299 | $494K |
| Vision | GUARDIAN | 100 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 41 | $31K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 29 | $35K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 164 | $165K |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 242 | $255K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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.