| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL ROBERSON3 Filed as: DANIEL S. ROBERSON | 2670 UNION AVENUE EXTENDED SUITE 100 MEMPHIS, TN 38112 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $20K | — | $20K | 5.46% |
| LARISSA L. BARTON3 | 23 WEATHERFORD SQUARE JACKSON, TN 38305 | NORTHWESTERN MUTUAL | $3K | $633 | $3K | 17.86% |
| RAY L. DUNN3 | 23 WEATHERFORD SQUARE Q JACKSON, TN 38305 | NORTHWESTERN MUTUAL | $251 | $90 | $341 | 1.94% |
| MEEKS FINANCIAL GROUP LLC3 Filed as: MEEKS FINANCIAL GROUP | FORUM 111 1770 KIRBY PARKWAY SUITE 400 MEMPHIS, TN 38138 | NORTHWESTERN MUTUAL | $251 | $30 | $281 | 1.60% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $105 | $2K | 12.43% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $1K | — | $1K | 15.00% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE SUITE 200 MEMPHIS, TN 38112 | USABLE LIFE | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONCERN EAP EIN 62-1278576 CONTRACTED EAP PROVIDER | Participant communication; Contract Administrator; Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 13 | — | $2K |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 119 | $367K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 119 | $367K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 119 | $367K |
| Life insurance | USABLE LIFE | 62 | $9K |
| Long-term disability | NORTHWESTERN MUTUAL | 127 | $18K |
| Other(2 contracts, 2 carriers) | AFLAC | 62 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.