| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: THE CRICHTON GROUP | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $45K | — | $45K | 8.00% |
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: THE CRICHTON GROUP | — | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 6.59% |
| DEBBIE PERKINS3 | 9655 BRUNSWICK DR. BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $777 | $256 | $1K | 5.32% |
| CARLA STINER REEL3 | 12322 MALLARD BAY DR. KNOXVILLE, TN 37922 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $268 | $60 | $328 | 1.69% |
| NICHOLAS MOOR WEISSFELD3 | 1309 KNIGHTSBRIDGE DR. KNOXVILLE, TN 37922 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $249 | $66 | $315 | 1.62% |
| POWELL & MEADOWS INSURANCE AGENCY3 | 910 MAIN STREET NORTH CARTHAGE, TN 37030 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $232 | — | $232 | 1.20% |
| LYNN MARIE BARRY3 | PO BOX 1287 LANGHORNE, PA 19047 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $165 | $56 | $221 | 1.14% |
| LVI BENEFITS SERVICES LLC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.77% |
| SHEILA A SHELL3 | 413 MOSS TRAIL GOODLETTSVILLE, TN 37072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.35% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.31% |
| DANIEL JAMES PERKINS3 | 9655 BRUNSWICK DR. BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.24% |
| DEBBIE RENEA CUNNINGHAM3 | 4006 WINDSONG TRAIL GREENBRIER, TN 37073 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.14% |
| LISA JENNETTE UNDERHILL3 | 1296 RED OAK DR. BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.14% |
| CRAIG GOODMAN LAWRENCE3 | 3326 ASPEN GROVE RD NASHVILLE, TN 37067 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.04% |
| TANJA DUARTE3 | 609 LUTHER RD. DICKSON, TN 37055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: THE CRICHTON GROUP | 3011 ARMORY DR., STE. 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $225 | $3K | 16.27% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $193 | $193 | 1.09% |
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: THE CRICHTON GROUP | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: THE CRICHTON GROUP | 3011 ARMORY DR., SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $939 | $67 | $1K | 16.06% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $58 | $58 | 0.93% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 176 | $565K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 176 | $565K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 88 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $24K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 23 | $19K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 176 | $565K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 110 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.