| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH RIDEOUT3 | 12 CADILLAC DRIVE, SUITE 160 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $5K | — | $5K | 7.10% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 15.00% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $3K | — | $3K | 13.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $2K | — | $2K | 11.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $755 | — | $755 | 3.72% |
| YOUR BENEFITS AGENCY INC3 Filed as: YOUR BENEFITS AGENCY, INC. | 17500 CHENAL PARKWAY, SUITE 150 LITTLE ROCK, AR 72223 | USABLE LIFE | $18 | — | $18 | 0.09% |
| BUSINESS MATTERS, INC3 Filed as: BUSINESS MATTERS INC. | P.O. BOX 863 SELMER, TN 38375 | USABLE LIFE | $742 | — | $742 | 5.90% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $629 | — | $629 | 5.00% |
| YOUR BENEFITS AGENCY INC3 Filed as: YOUR BENEFITS AGENCY, INC. | 17500 CHENAL PARKWAY, SUITE 150 LITTLE ROCK, AR 72223 | USABLE LIFE | $280 | — | $280 | 2.23% |
| HARRY STANSBURY3 | 57 BAILEY WOODS LANE #202 COLLIERVILLE, TN 38017 | USABLE LIFE | $260 | — | $260 | 2.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $236 | — | $236 | 1.88% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 9.43% |
| BUSINESS MATTERS, INC3 Filed as: BUSINESS MATTERS INC. | PO BOX 863 SELMER, TN 38375 | USABLE LIFE | $565 | — | $565 | 5.64% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $510 | — | $510 | 5.09% |
| ANDREW MEADOWS3 | 1071 ASHMORE DRIVE NASHVILLE, TN 37211 | USABLE LIFE | $398 | — | $398 | 3.97% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $299 | — | $299 | 2.98% |
| HARRY STANSBURY3 | 57 BAILEY WOODS LANE #202 COLLIERVILLE, TN 38017 | USABLE LIFE | $221 | — | $221 | 2.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $647 | — | $647 | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $502 | $86 | $588 | 13.63% |
| BUSINESS MATTERS, INC3 Filed as: BUSINESS MATTERS INC. | P.O. BOX 863 SELMER, TN 38375 | USABLE LIFE | $198 | — | $198 | 5.38% |
| YOUR BENEFITS AGENCY INC3 Filed as: YOUR BENEFITS AGENCY, INC. | 17500 CHENAL PARKWAY, SUITE 150 LITTLE ROCK, AR 72223 | USABLE LIFE | $180 | — | $180 | 4.89% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $152 | — | $152 | 4.13% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $92 | — | $92 | 2.50% |
| HARRY STANSBURY3 | 57 BAILEY WOODS LANE #202 COLLIERVILLE, TN 38017 | USABLE LIFE | $85 | — | $85 | 2.31% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $240 | — | $240 | 13.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $208 | — | $208 | 11.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $69 | — | $69 | 3.74% |
| YOUR BENEFITS AGENCY INC3 Filed as: YOUR BENEFITS AGENCY, INC. | 17500 CHENAL PARKWAY, SUITE 150 LITTLE ROCK, AR 72223 | USABLE LIFE | $4 | — | $4 | 0.22% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $124 | — | $124 | 9.44% |
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 | 264 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 264 | $77K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 264 | $77K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 264 | $77K |
| Life insurance(4 contracts, 2 carriers) | USABLE LIFE | 170 | $38K |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 170 | $38K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 170 | $27K |
| Other(2 contracts) | USABLE LIFE | 42 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.