| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT TIMOTHY SINKS3 Filed as: ROBERT S PETREE | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $22K | — | $22K | 1.71% |
| ROBIN K MATHIS3 | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $10K | — | $10K | 0.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ | — | HBA ADMINISTRATORS | $2K | — | $2K | 2.72% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ | — | HBA ADMINISTRATORS | $2K | — | $2K | 2.72% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 NORTH FRANKLIN STREET SUITE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $580 | $5K | 9.42% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES I | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37229 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $863 | — | $863 | 1.76% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $812 | $812 | 1.66% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 NORTH FRANKLIN STREET SUITE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | — | $13K | 55.48% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES I | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.85% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $156 | — | $156 | 0.67% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $2K | — | $2K | 14.15% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF TENNESSEE INC | 10151 DEERWOOD PARK BOULEVARD B100 SUITE 500 JACKSONVILLE, FL 32256 | USABLE LIFE | $2K | — | $2K | 14.15% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 NORTH FRANKLIN STREET SUITE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 55.53% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.54% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $295 | — | $295 | 1.98% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 655 NORTH FRANKLIN STREET SUITE 1900 TAMPA, FL 33602 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $959 | — | $959 | 8.20% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 6 CADILLAC DRIVE SUITE 200 BRENTWOOD, TN 37229 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $211 | — | $211 | 1.80% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 10151 DEERWOOD PARK BOULEVARD B100 SUITE 500 JACKSONVILLE, FL 32256 | USABLE LIFE | $861 | — | $861 | 14.99% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $600 | $115 | $715 | 12.45% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 92 | $1.3M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $49K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $12K |
| Life insurance | USABLE LIFE | 89 | $6K |
| Short-term disability | USABLE LIFE | 29 | $17K |
| Other(4 contracts, 3 carriers) | HBA ADMINISTRATORS | 106 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.