| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENJAMIN WEBB SABIN3 | 7405 CORNUTA LANE GERMANTOWN, TN 38138 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 7.50% |
| KENNETH PAYLOR3 | 5100 POPLAR AVENUE, SUITE 1200 MEMPHIS, TN 38157 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $8K | — | $8K | 4.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $10K | $10K | 6.56% |
| SENIOR COMMISSION FUNDING LLC3 | 6201 PRESIDENTIAL CT FORT MYERS, FL 33919 | TRANSAMERICA LIFE INSURANCE COMPANY | $9K | — | $9K | 14.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD TENNESSEE EIN 62-0427913 CLAIMS ADMINISTRATION | Contract Administrator; Other services; Claims processing Service code 12 | 161 HEART DRIVE JOHNSON CITY, TN 37604 | $105K |
| KENNETH D PAYLOR BROKER | Insurance agents and brokers Service code 22 | 5100 POPLAR AVENUE STE 1200 MEMPHIS, TN 38137 | $5K |
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 | 250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 548 | $189K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 548 | $189K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 548 | $189K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $155K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 277 | $253K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 548 | $189K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 548 | $189K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.