| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL BARCROFT3 Filed as: PAUL W BARCROFT | 999 S SHADY GROVE ROAD SUITE 200 MEMPHIS, TN 38120 | BLUERE OF TENNESSEE | $10K | — | $10K | 3.27% |
| JONATHAN L PENNINGTON3 Filed as: JONATHAN L. PENNINGTON | 1154 RAVENNA CV COLLIERVILLE, TN 38017 | AFLAC | $592 | $22 | $614 | 3.57% |
| TODD R EATON3 Filed as: TODD R. EATON | 6971 HEARTHSIDE CV MEMPHIS, TN 38119 | AFLAC | $518 | — | $518 | 3.01% |
| CAROLYN H BOLIN3 Filed as: CAROLYN H. BOLIN | 5284 SUMMER WIND LANE ARLINGTON, TN 38002 | AFLAC | $503 | — | $503 | 2.93% |
| QUINTON J MILES3 Filed as: QUINTON J. MILES | P.O. BOX 22434 CHARLESTON, SC 29413 | AFLAC | $115 | — | $115 | 0.67% |
| TIMOTHY J REED3 Filed as: TIMOTHY S. INGRAM | 1731 MOUNT ZION ROAD JACKSONVILLE, IL 62650 | AFLAC | $86 | — | $86 | 0.50% |
| HOWARD EATON3 | 3141 PRAIRIE ROSE DRIVE NORWALK, IA 50211 | AFLAC | $76 | — | $76 | 0.44% |
| WILLIAM T GANT3 | 117 HILLSONG LN BRIGHTON, TN 38011 | AFLAC | $67 | $5 | $72 | 0.42% |
| AMANDA SARGENT3 | 3685 COLLEGE BLF OLIVE BRANCH, MS 38654 | AFLAC | $71 | — | $71 | 0.41% |
| KENNETH BRADLEY ELDRED3 | 611 BELMONT ESTATES DRIVE HERNANDO, MS 38632 | AFLAC | $66 | — | $66 | 0.38% |
| KATRINA T. GRAHAM3 | 4431 LUGARDA LANE MEMPHIS, TN 38125 | AFLAC | $58 | — | $58 | 0.34% |
| DAVID S. LIESKE3 | 3441 WOLF SPRING LANE BARTLETT, TN 38133 | AFLAC | $44 | — | $44 | 0.26% |
| NANCY D WEBB3 Filed as: NANCY D. WEBB | 1856 PENSHURST DRIVE COLLIERVILLE, TN 38017 | AFLAC | $37 | — | $37 | 0.22% |
| BELINDA JEAN LEGGETT3 | 93 GEORGE ELLIS DR MUNFORD, TN 38058 | AFLAC | $29 | $5 | $34 | 0.20% |
| LARRY D GROVES3 | 309 COLERIDGE DRIVE DUNN, NC 28334 | AFLAC | $29 | — | $29 | 0.17% |
| ROBERT L GOBLE3 | 250 34TH AVE NE HICKORY, NC 28601 | AFLAC | $27 | — | $27 | 0.16% |
| JAMES D STEPHENS3 Filed as: JAMES D. STEPHENS | 26710 MANDRAKE FALLS COURT KATY, TX 77494 | AFLAC | $21 | — | $21 | 0.12% |
| KATHRYN SUZANNE AXENTE3 | 7020 PELICAN ISLAND DRIVE TAMPA, FL 33634 | AFLAC | $21 | — | $21 | 0.12% |
| MIKE N SEWELL3 | 301 CLAYMORE DR HAMILTON, GA 31811 | AFLAC | $20 | — | $20 | 0.12% |
| PHILLIP L DAGASTINO3 | 5301 PECAN GROVE LN MEMPHIS, TN 38120 | AFLAC | $14 | — | $14 | 0.08% |
| VBTN, INC3 Filed as: VBTN, INC. | 2000 GLEN ECHO ROAD SUITE 204 NASHVILLE, TN 37215 | AFLAC | $9 | — | $9 | 0.05% |
| DAVID L KLEVAN3 Filed as: DAVID KLEVAN | P.O. BOX 38219 GERMANTOWN, TN 38183 | AFLAC | $5 | — | $5 | 0.03% |
| JAY S OLEARY3 Filed as: JAY S. OLEARY | 1802 EAVES COURT NOLENSVILLE, TN 37135 | AFLAC | $4 | — | $4 | 0.02% |
| PAMELA W EZZELL3 Filed as: PAMELA W. EZZELL | 2947 CHERRYBARK COURT HERMITAGE, TN 37076 | AFLAC | $4 | — | $4 | 0.02% |
| BRAD FREDERIKSEN3 | 31 FAIRWAY WOODS CIR MAUMELLE, AR 72113 | AFLAC | $2 | — | $2 | 0.01% |
| ALAN W MARTIN3 | 12524 MALLARD BAY DRIVE KNOXVILLE, TN 37922 | AFLAC | $2 | — | $2 | 0.01% |
| JOANNA G MATHERLY3 Filed as: JOANNA G. MATHERLY | 4581 MAJESTIC MEADOWS DR ARRINGTON, TN 37014 | AFLAC | $2 | — | $2 | 0.01% |
| BRADLEY BOLICK3 Filed as: BRADLEY S BOLICK | 6433 FALL BRANCH DRIVE COLUMBUS, GA 31904 | AFLAC | $2 | — | $2 | 0.01% |
| AMY B CITRON3 Filed as: AMY CITRON | 1024 GRANADA AVENUE NASHVILLE, TN 37206 | AFLAC | $2 | — | $2 | 0.01% |
| RONALD H RICHEY3 Filed as: RONALD H. RICHEY | 4499 MURFREESBORO ROAD FRANKLIN, TN 37067 | AFLAC | $1 | — | $1 | 0.01% |
| KEITH R MOORE3 Filed as: KEITH R. MOORE | 135 WALNUT CREEK ROAD CORDOVA, TN 38018 | AFLAC | $1 | — | $1 | 0.01% |
| ROGER MURRAY JOHNSON3 | 5936 ENCLAVE DRIVE MURFREESBORO, TN 37128 | AFLAC | $1 | — | $1 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 | 6000 POPLAR AVE STE 300 MEMPHIS, TN 38119 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $582 | $582 | 3.78% |
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 | 187 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUERE OF TENNESSEE | 393 | $306K |
| Vision | BLUECROSS BLUE SHIELD OF TENNESSEE, INC. | 401 | $17K |
| Life insurance | USABLE LIFE | 203 | $41K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $15K |
| Other(2 contracts, 2 carriers) | USABLE LIFE | 203 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.