| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JILL E. BACHUSS3 | PO BOX 1507 SAVANNAH, TN 38372 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $19K | $0 | $19K | 3.78% |
| THE HARDIN COUNTRY BANK INS AGENCY3 | PO BOX 1507 SAVANNAH, TN 38372 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 7.38% |
| LINDA R MARCUM3 Filed as: LINDA R. MARCUM | 1147 NORTH BROAD STREET LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.18% |
| KINDA JACKSON3 | 1811 BROOKSIE THOMPSON ROAD DECATURVILLE, TN 38329 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $903 | $10 | $913 | 0.93% |
| VICTORIA L FLYNN3 Filed as: VICTORIA L. FLYNN | 7009 FAIRVIEW ROAD CORRYTON, TN 37721 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $873 | $0 | $873 | 0.89% |
| KAREN W GORDON3 Filed as: KAREN W. GORDON | 390 MASTERS DRIVE LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $736 | $0 | $736 | 0.75% |
| CAROL BASS3 Filed as: CAROL BASS AND OTHER AGENTS | 645 OLD HICKORY BOULEVARD APARTMENT 505 NASHVILLE, TN 37209 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $518 | $49 | $567 | 0.58% |
| MICHAEL A DUARTE3 Filed as: MICHAEL A. DUARTE | 515 DULL STREET DICKSON, TN 37055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $523 | $0 | $523 | 0.53% |
| THE HARDIN COUNTY BANK INS AGY INC3 | 235 WAYNE ROAD SAVANNAH, TN 28372 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 12.02% |
| THE HARDIN COUNTY BANK INS AGY, INC3 | 235 WAYNE ROAD SAVANNAH, TN 28372 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 12.02% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 93 | $499K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 93 | $499K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 93 | $499K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 111 | $141K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 111 | $98K |
| Long-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 107 | $31K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 93 | $499K |
| Other(3 contracts, 3 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 111 | $640K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.