| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HANES TORBETT3 | 2306 KNOB CREEK RD STE 104 JOHNSON CITY, TN 37604 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $65K | — | $65K | 4.30% |
| STEPHEN L FOSTER3 Filed as: STEPHEN L. FOSTER | PO BOX 4334 CRS JOHNSON CITY, TN 37602 | AFLAC | $6K | $910 | $7K | 8.46% |
| MARK EDWARD CASE3 | 920 HOLCOMB BRIDGE RD STE 200 ROSWELL, GA 30076 | AFLAC | $1K | $460 | $2K | 2.39% |
| JEFFREY GASTON COPELAND3 | 12 VILLAGE LN NEWNAN, GA 30265 | AFLAC | $1K | — | $1K | 1.92% |
| JACKSON D RHODES3 Filed as: JACKSON D. RHODES | 525 W. OAKLAND AVE, STE 7 JOHNSON CITY, TN 37604 | AFLAC | $1K | $182 | $1K | 1.65% |
| LYNN HODGE3 | 32 EARHART RD BLUFF CITY, TN 37618 | AFLAC | $848 | $179 | $1K | 1.33% |
| VBTN, INC3 | 301 MALLORY STATION RD STE 100 FRANKLIN, TN 37067 | AFLAC | $454 | $182 | $636 | 0.83% |
| RYAN DREBING3 Filed as: RYAN A, DREBING | 67 CARTERS VIEW WAY TELFORD, TN 37690 | AFLAC | $588 | $3 | $591 | 0.77% |
| BRIAN D ELY3 Filed as: BRIAN D. ELY | P.O. BOX 723581 ATLANTA, GA 31139 | AFLAC | $502 | — | $502 | 0.65% |
| KEITH ANTHONY KLEINE3 | 2216 SPRUCEWOOD DR, NW ACWORTH, GA 30101 | AFLAC | $279 | — | $279 | 0.36% |
| KIMBERLY STATEN3 Filed as: KIMBERLY B. STATEN | PO BOX 8184 GRAY, TN 37615 | AFLAC | $260 | — | $260 | 0.34% |
| CHARLES HOUGH3 Filed as: CHARLES C. HOUGH | 575 SAND RIDGE CIR JONESBOROUGH, TN 37659 | AFLAC | $200 | — | $200 | 0.26% |
| ANDREA R BROCK3 Filed as: ANDREA R. BROCK | 4229 MOUNTAIN RIDGE ROAD GAINESVILLE, GA 30506 | AFLAC | $157 | — | $157 | 0.20% |
| EDWARDS TIPTON WITT AGENCY3 Filed as: EDWARDS, TIPTON, WITT AGENCY | PO BOX 747 KINGSPORT, TN 37662 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $61 | — | $61 | 3.79% |
| KAREN TOBIAS3 | 1366 DUNRAVEN DR MURFREESBORO, TN 37128 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $7 | — | $7 | 0.43% |
| JERRY W HOOPER3 Filed as: JERRY W. HOOPER | 741 BRESSLYN RD NASHVILLE, TN 37205 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $6 | — | $6 | 0.37% |
| DENNIS E TRAYWICK3 Filed as: DENNIS TRAYWICK | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $5 | — | $5 | 0.31% |
| BRENDA H BRIDGES3 Filed as: BRENDA H. BRIDGES | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $4 | — | $4 | 0.25% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $4 | — | $4 | 0.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAVERS ADMINISTRATIVE SERVICES EIN 57-1177739 HRA ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
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 | 197 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 372 | $1.5M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 372 | $1.5M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 372 | $1.5M |
| Other(2 contracts, 2 carriers) | AFLAC | 133 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.