| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HANES TORBETT3 | 508 PRINCETON RD STE 102 JOHNSON CITY, TN 37601 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $61K | — | $61K | 3.69% |
| STEPHEN L FOSTER3 Filed as: STEPHEN L. FOSTER | PO BOX 4334 JOHNSON CITY, TN 37602 | AFLAC | $8K | $118 | $8K | 7.98% |
| JACKSON D RHODES3 Filed as: JACKSON D. RHODES | 2332 VOLUNTEER PKWY BRISTOL, TN 37620 | AFLAC | $2K | $24 | $2K | 1.53% |
| JEFFREY GASTON COPELAND3 | 100 HARTSFIELD CENTER PKWY STE 500 ATLANTA, GA 30354 | AFLAC | $1K | — | $1K | 1.23% |
| RYAN DREBING3 Filed as: RYAN A. DREBING | 2112 N ROAN ST SUITE 702 JOHNSON CITY, TN 37601 | AFLAC | $1K | $24 | $1K | 1.21% |
| AMANDA L MOORE RHODES3 Filed as: AMANDA L. MOORE RHODES | 327 CHARLTON CT BLUFF CITY, TN 37618 | AFLAC | $759 | — | $759 | 0.76% |
| MARK EDWARD CASE3 | 6821 WELLINGTON PL CASTLE PINES, CO 80108 | AFLAC | $618 | — | $618 | 0.62% |
| LYNN B HODGE3 Filed as: LYNN B. HODGE | 430 ALFALFA LN JONESBOROUGH, TN 37659 | AFLAC | $550 | — | $550 | 0.55% |
| BRIAN D ELY3 Filed as: BRIAN D. ELY | 1820 THE EXCHANGE SE STE 750 ATLANTA, GA 30339 | AFLAC | $482 | — | $482 | 0.48% |
| KEITH ANTHONY KLEINE3 Filed as: KEITH ANTHONY KLEIN | 2216 SPRUCEWOOD DR NW ACWORTH, GA 30101 | AFLAC | $259 | — | $259 | 0.26% |
| KIMBERLY STATEN3 Filed as: KIMBERLY B. STATEN | PO BOX 8184 GRAY, TN 37615 | AFLAC | $226 | — | $226 | 0.23% |
| CHARLES HOUGH3 Filed as: CHARLES C. HOUGH | 162 SLATE HILL RD TELFORD, TN 37690 | AFLAC | $173 | — | $173 | 0.17% |
| VBTN, INC3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $171 | — | $171 | 0.17% |
| EDWARDS TIPTON WITT AGENCY3 | PO BOX 747 KINGSPORT, TN 37662 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $21 | — | $21 | 3.29% |
| BRENDA H BRIDGES3 Filed as: BRENDA H. BRIDGES | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $4 | — | $4 | 0.63% |
| KAREN TOBIAS3 | 1366 DUNRAVEN DR MURFREESBORO, TN 37128 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $2 | — | $2 | 0.31% |
| DENNIS E TRAYWICK3 Filed as: DENNIS E. TRAYWICK | 4701 TROUSDALE DR NASHVILLE, TN 37220 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $2 | — | $2 | 0.31% |
| MARK CHRISTOPHER HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $2 | — | $2 | 0.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAVERS ADMINISTRATIVE SERVICES EIN 57-1177739 SEC 125 ADMINSTR | Contract Administrator Service code 13 | — | $11K |
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 | 249 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 406 | $1.6M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 406 | $1.6M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 406 | $1.6M |
| Other(2 contracts, 2 carriers) | AFLAC | 117 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.