| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SIMMONS FIRST INSURANCE SERVICES3 Filed as: SIMMONS FIRST INSURANCE SERVICES OF | 480 OIL WELL RD JACKSON, TN 38305 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $6K | — | $6K | 5.12% |
| BENEFITS FIRST LLC3 | PO BOX 766 LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $5K | $359 | $5K | 4.95% |
| DORIS LINDA MARTIN3 | PO BOX 375 LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $4K | $368 | $4K | 3.88% |
| STEVEN BREWER3 Filed as: STEVEN P LINDSEY | PO BOX 766 LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $747 | — | $747 | 0.68% |
| ANNA DAVIS3 Filed as: ANNA M DAVIS | PO BOX 766 LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $677 | — | $677 | 0.61% |
| KAREN W GORDON3 Filed as: KAREN W GHORDON | 390 MASTERS DR LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $118 | — | $118 | 0.11% |
| KINDA JACKSON3 | 1811 BROOKSIE THOMPSON RD DECATURVILLE, TN 38329 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $40 | — | $40 | 0.04% |
| BETTY C HAYNES3 | 5513 POPLAR CORNER RD BROWNSVILLE, TN 38012 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $13 | — | $13 | 0.01% |
| LINDA R MARCUM3 | 1147 N BROAD ST LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $13 | — | $13 | 0.01% |
| MARK CHRISTOPHER HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $5 | $5 | $10 | 0.01% |
| ROBERT E HIGDON3 | 1016 VENUS DR LAWRENCEBURG, KY 40342 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $8 | — | $8 | 0.01% |
| ELLIS INSURANCE AGENCY3 | 382 CARRIAGE HOUSE DR STE A AND B JACKSON, TN 38305 | USABLE LIFE | $5K | — | $5K | 14.85% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $2K | — | $2K | 6.93% |
| ELLIS INSURANCE AGENCY3 | 382 CARRIAGE HOUSE DR STE A AND B JACKSON, TN 38305 | USABLE LIFE | $4K | — | $4K | 14.85% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $2K | — | $2K | 6.93% |
| JOHN T HARRIS3 | 451 DIVISION ST NE SALEM, OR 97301 | BLUECROSS BLUESHIELD OF TENNESSEE INC | $6K | — | $6K | 30.57% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 26.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $87K |
| CU BENEFITS ALLIANCE EIN 61-1691027 BROKER | Other commissions Service code 55 | — | $53K |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $17K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE INC | 363 | $21K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE CO | 191 | $141K |
| Long-term disability | USABLE LIFE | 191 | $24K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE | 363 | $218K |
| Other | USABLE LIFE | 191 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.