No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTHCARE EIN 06-0303370 NONE | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | 1111 MARKET ST CHATTANOOGA, TN 37402 | $109K |
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Plan Administrator; Consulting (general) Service code 14 | P.O. BOX 1449 GOODLETTSVILLE, TN 37070 | $89K |
| DANIELS IRWIN & AYLOR EIN 62-1802605 NONE | Accounting (including auditing) Service code 10 | 223 MADISON ST. SUITE 112 MADISON, TN 37115 | $12K |
| GODWIN, MORRIS, LAURENZI, BLOOMFIEL EIN 62-1371542 NONE | Legal Service code 29 | P.O. BOX 3290 MEMPHIS, TN 381730290 | $11K |
| MERRILL LYNCH EIN 13-5674085 NONE | Investment management Service code 28 | 4 WORLD FINANCIAL CENTER NEW YORK, NY 10281 | $6K |
| MUTUAL FUND NONE | Custodial (securities); Investment management Service code 19 | — | $0 |
| U.S. BANK EIN 31-0841368 NONE | Investment management; Custodial (securities) Service code 19 | 1555 N. RIVERCENTER 300 MILWAUKEE, WI 53212 | $0 |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 51 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 277 | $179K |
| Life insurance | FORT DEARBORN LIFE INSURANCE COMPANY | 277 | $35K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE | 277 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.