| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN HOLLINGSWORTH3 | 1217 RYAN PLACE KNOXVILLE, TN 37919 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | $40K | — | $40K | 7.16% |
| BEN HOLLINGSWORTH3 Filed as: J. BEN HOLLINGSWORTH | 1216 RYAN PLACE KNOXVILLE, TN 37919 | COMPANION LIFE | $610 | — | $610 | 8.52% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | ONE CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | COMPANION LIFE | $358 | — | $358 | 5.00% |
| TRINITY BENEFIT ADVISORS, INC.3 | 4823 OLD KINGSTON PIKE STE 300 KNOXVILLE, TN 37919 | COMPANION LIFE | $106 | — | $106 | 1.48% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | 100 | $563K |
| Dental | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | 100 | $563K |
| Vision | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | 100 | $563K |
| Life insurance | COMPANION LIFE | 142 | $7K |
| Short-term disability | COMPANION LIFE | 142 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.