| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 3011 ARMORY DR #250 NASHVILLE, TN 37204 | STANDARD INSURANCE COMPANY | $10K | — | $10K | 6.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 3011 ARMORY DR #250 NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 27.80% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF TENNESSEE | $2K | $0 | $2K | 16.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 | Insurance services; Claims processing Service code 12 | — | $40K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $9K |
| STANDARD INSURANCE COMPANY EIN 93-0242990 | Claims processing Service code 12 | — | $5K |
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 | 138 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 198 | $513K |
| Vision | DELTA DENTAL OF TENNESSEE | 284 | $14K |
| Life insurance | STANDARD INSURANCE COMPANY | 138 | $145K |
| Long-term disability | STANDARD INSURANCE COMPANY | 138 | $145K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 138 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.