| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM THOMAS3 | PO BOX 10328 KNOXVILLE, TN 37939 | BLUERE OF TENNESSEE | $52K | — | $52K | 15.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES, INC. | 1900 SUITE 100 KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 15.00% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER, LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $105 | — | $105 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 RECORDKEEPER | Contract Administrator Service code 13 | — | $101K |
| WILLIAM THOMAS BROKER | Insurance agents and brokers Service code 22 | PO BOX 10328 KNOXVILLE, TN 37939 | $85K |
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 | 663 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 668 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $136K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $136K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $136K |
| Stop-loss / reinsurancereinsurance | BLUERE OF TENNESSEE | 663 | $328K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 663 | — |
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.