| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH RIDEOUT3 | 12 CADILLAC DRIVE, SUITE 160 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $49K | — | $49K | 3.90% |
| THOMAS W BOSTON3 Filed as: THOMAS A. DAMPF | 4205 HILLSBORO PIKE, SUITE 120 NASHVILLE, TN 37215 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $17K | — | $17K | 1.32% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 10.00% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $4K | $907 | $5K | 18.14% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $3K | $0 | $3K | 13.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $2K | $0 | $2K | 10.47% |
| PANCOAST & ASSOCIATES INC3 Filed as: PANCOAST AND ASSOCIATES, INC | 4205 HILLSBORO PIKE, SUITE 120 NASHVILLE, TN 37215 | USABLE LIFE | $894 | $0 | $894 | 4.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 75263 | UNITED HEALTHCARE INSURANCE COMPANY | $827 | $0 | $827 | 6.38% |
| PANCOAST & ASSOCIATES INC3 Filed as: PANCOAST AND ASSOCIATES, INC | 4205 HILLSBORO PIKE, SUITE 120 NASHVILLE, TN 37215 | UNITED HEALTHCARE INSURANCE COMPANY | $470 | $0 | $470 | 3.62% |
| DONALD HURWITZ3 | 1600 DIVISION STREET, SUITE 400 NASHVILLE, TN 37203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 9.26% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $641 | $116 | $757 | 13.09% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $524 | $0 | $524 | 9.06% |
| PANCOAST & ASSOCIATES INC3 Filed as: PANCOAST AND ASSOCIATES, INC | 4205 HILLSBORO PIKE, SUITE 120 NASHVILLE, TN 37215 | USABLE LIFE | $344 | $0 | $344 | 5.95% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES INC. | 1 CAMERON HILL CIRCLE - 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $204 | $0 | $204 | 13.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $163 | $0 | $163 | 10.39% |
| PANCOAST & ASSOCIATES INC3 Filed as: PANCOAST AND ASSOCIATES, INC | 4205 HILLSBORO PIKE, SUITE 120 NASHVILLE, TN 37215 | USABLE LIFE | $72 | $0 | $72 | 4.59% |
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 | 268 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 268 | $1.3M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 268 | $1.3M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 268 | $1.3M |
| Life insurance(4 contracts, 2 carriers) | USABLE LIFE | 181 | $39K |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 181 | $31K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 181 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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.