| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLE HARRIS3 | 9648 KINGSTON PIKE SUITE 8 KNOXVILLE, TN 37922 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $55K | $0 | $55K | 3.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINATTI, OH 45263 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 35.99% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $85 | $85 | 0.25% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SRVC. | PO BOX 632886 CINCINATTI, OH 45263 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| GROUP INSURANCE SERVICE INC3 Filed as: GROUP INSURANCE SERVICE | 801 PINE ST. HUB BLDG. 3B CHATTANOOGA, TN 37402 | MAGELLAN BEHAVIORAL HEALTH | $806 | $0 | $806 | 12.00% |
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 | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 381 | $1.5M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 381 | $1.5M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 140 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 262 | $29K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 262 | $34K |
| Other(6 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 284 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 381 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.