| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM THOMAS3 Filed as: WILLIAM THOMAS SR | 1900 NORTH WINSTON ROAD KNOXVILLE, TN 37919 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $54K | — | $54K | 5.67% |
| MARK F. GRABER3 | 9111 CROSS PARK DRIVE D-200 KNOXVILLE, TN 37923 | DELTA DENTAL OF TENNESSEE | $7K | — | $7K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INS SERVICES INC | 1900 NORTH WINSTON ROAD KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 18.63% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK ATTN DENISE STEFANOFF BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $865 | $865 | 3.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INS SERVICES INC | 1900 NORTH WINSTON ROAD KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $855 | $5K | 18.49% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK ATTN DENISE STEFANOFF BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $733 | $733 | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INS SERVICES INC | 1900 NORTH WINSTON ROAD KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $553 | $3K | 18.19% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK ATTN DENIS STEFANOFF BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $474 | $474 | 2.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | SYMETRA LIFE INSURANCE COMPANY | $908 | — | $908 | 7.47% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | SYMETRA LIFE INSURANCE COMPANY | $182 | $247 | $429 | 3.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INS SERVICES INC | 1900 NORTH WINSTON ROAD KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $483 | $109 | $592 | 18.40% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK ATTN DENISE STEFANOFF BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $94 | $94 | 2.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INS SERVICES INC | 1900 NORTH WINSTON ROAD KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $343 | $84 | $427 | 18.68% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK ATTN DENISE STEFANOFF BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $72 | $72 | 3.15% |
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 | 94 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 94 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF TENNESSEE | 175 | $67K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 94 | $955K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $31K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 55 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 73 | $17K |
| Prescription drug | SYMETRA LIFE INSURANCE COMPANY | 16 | $12K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.