No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Actuarial; Plan Administrator; Consulting (general) Service code 11 | P.O. BOX 1449 GOODLETTSVILLE, TN 37070 | $87K |
| UNITED HEALTHCARE EIN 36-2739571 NONE | Claims processing Service code 12 | 5901 LINCOLN DRIVE MINNEAPOLIS, MN 55436 | $36K |
| CIGNA EIN 06-0303370 NONE | Contract Administrator; Non-monetary compensation; Claims processing; Named fiduciary; Participant communication; Other services; Direct payment from the plan; Float revenue Service code 12 | 1111 MARKET ST SUITE 112 CHATTANOOGA, TN 37402 | $29K |
| ATLANTA CAPITAL MANAGEMENT EIN 58-2236910 NONE | Investment management Service code 28 | 1349 PEACHTREE ST. 1600 ATLANTA, GA 30309 | $18K |
| DANIELS, IRWIN & AYLOR EIN 62-1802605 NONE | Accounting (including auditing) Service code 10 | 223 MADISON ST SUITE 112 MADISON, TN 37115 | $14K |
| GODWIN, MORRIS, LAURENZI & BLOOMFIE EIN 62-1371542 NONE | Legal Service code 29 | P.O. BOX 3290 MEMPHIS, TN 381730290 | $7K |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | 5 STAR LIFE INSURANCE COMPANY | 244 | $23K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 244 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.