| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM THOMAS3 Filed as: WILLIAM THOMAS SR | 1900 NORTH WINSTON ROAD SUITE KNOXVILLE, TN 37919 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $48K | — | $48K | 5.59% |
| MARK F. GRABER3 | 9111 CROSS PARK DRIVE D-200 KNOXVILLE, TN 37923 | DELTA DENTAL OF TENNESSEE | $7K | — | $7K | 10.00% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $5K | — | $5K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $5K | — | $5K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $5K | — | $5K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERIVCES INC | PO BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $5K | — | $5K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $3K | — | $3K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $1K | — | $1K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | SYMETRA LIFE INSURANCE COMPANY | $984 | — | $984 | 8.95% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | SYMETRA LIFE INSURANCE COMPANY | $197 | $208 | $405 | 3.68% |
| LIPSCOMB & PITTS INSURANCE LLC3 Filed as: LIPSCOMB AND PITTS INSURANCE L | 2670 UNION AVENUE EXTENDED SUITE 200 MEMPHIS, TN 38112 | SYMETRA LIFE INSURANCE COMPANY | — | -$1 | -$1 | -0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $730 | — | $730 | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $341 | — | $341 | 7.00% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $417 | — | $417 | 14.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $417 | — | $417 | 14.98% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $271 | — | $271 | 15.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | PO BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $271 | — | $271 | 15.01% |
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 | 185 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF TENNESSEE | 185 | $69K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $868K |
| Life insurance(2 contracts) | USABLE LIFE | 95 | $35K |
| Short-term disability(2 contracts) | USABLE LIFE | 53 | $35K |
| Long-term disability | USABLE LIFE | 64 | $19K |
| Prescription drug | SYMETRA LIFE INSURANCE COMPANY | 36 | $11K |
| Other(6 contracts, 2 carriers) | USABLE LIFE | 95 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.