| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | AMERICAN FIDELITY | $76K | — | $76K | 8.00% |
| AERON JAMES LUCAS | 113 SEABOARD LANE, C170 HUB INTERNATIONAL, DOVER CENTER FRANKLIN, TN 37067 | AMERICAN FIDELITY | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 SAME | Contract Administrator Service code 13 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | $2.3M |
| DIALYSIS CLINIC INC EIN 62-0850498 SAME | Plan Administrator Service code 14 | 1633 CHURCH ST SUITE 500 NASHVILLE, TN 37203 | $938K |
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 | 4,164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN FIDELITY | 4,316 | $949K |
| Dental | AMERICAN FIDELITY | 4,316 | $949K |
| Vision | AMERICAN FIDELITY | 4,316 | $949K |
| Prescription drug | AMERICAN FIDELITY | 4,316 | $949K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,316 | — |
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.