| 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. | $40K | — | $40K | 6.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | — | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $139 | $1K | 6.81% |
| DEBBIE PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $881 | $82 | $963 | 4.45% |
| LYNN MARIE BARRY3 | PO BOX 1287 LANGHORNE, PA 19047 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $224 | $92 | $316 | 1.46% |
| LISA JENNETTE UNDERHILL3 | 1296 RED OAK DR. BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $304 | $9 | $313 | 1.45% |
| CRICHTON BRANDON JACKSON & WARD INC3 Filed as: THE CRICHTON GROUP | — | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $251 | — | $251 | 1.16% |
| POWELL & MEADOWS INSURANCE AGENCY3 | 910 MAIN STREET NORTH CARTHAGE, TN 37030 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $199 | — | $199 | 0.92% |
| DETRA HARDIMAN3 | 9300 HIDDEN OAK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | — | $172 | 0.80% |
| CARLA STINER REEL3 | 12322 MALLARD BAY DRIVE KNOXVILLE, TN 37922 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $146 | $19 | $165 | 0.76% |
| NICHOLAS MOOR WEISSFELD3 | 1309 KNIGHTSBRIDGE DR. KNOXVILLE, TN 37922 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $137 | $24 | $161 | 0.74% |
| LVI BENEFITS SERVICES LLC3 Filed as: LVI BENEFITS SERVICES, LLC | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.61% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37067 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.29% |
| SHEILA A SHELL3 | 413 MOSS TRAIL GOODLETTSVILLE, TN 37072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | — | $57 | 0.26% |
| DEBBIE RENEA CUNNINGHAM3 | 4006 WINDSONG TRAIL GREENBRIER, TN 37073 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.11% |
| CRAIG GOODMAN LAWRENCE3 | 3326 ASPEN GROVE RD. NASHVILLE, TN 37067 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.05% |
| DANIEL JAMES PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 ARMORY DR., STE. 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 22.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 ARMORY DR., SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $950 | $451 | $1K | 22.12% |
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 | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $609K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $609K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $609K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $23K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 25 | $22K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 185 | $609K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 110 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.