| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH LARSHUS3 | 801 A SUNSET DRIVE SUITE 2 JOHNSON CITY, TN 37604 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $39K | — | $39K | 3.38% |
| PAUL COOK3 | PO BOX 669 GREENVILLE, TN 37744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 7.01% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL DRIVE SUITE 201 KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 3.91% |
| JM TAMER & CO3 | 6500 PAPERMILL DRIVE SUITE 201 KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $50 | $3K | 2.64% |
| CARLA BURWELL3 Filed as: CARLA E BURWELL | 3012 WESLEY ROAD SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $51 | $1K | 1.17% |
| MARY DAUGHERTY3 | PO BOX 119 ROCKY TOP, TX 37769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $452 | — | $452 | 0.41% |
| VICTORIA L FLYNN3 | 7009 FAIRVIEW ROAD CORRYTON, TN 37721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | — | $230 | 0.21% |
| CAROL BASS3 | 645 OLD HICKORY BOULEVARD APARTMENT 505 NASHVILLE, TN 37209 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $188 | $14 | $202 | 0.18% |
| SUSAN FONTANA FLYNN3 | 8814 EAGLE POINTE DRIVE KNOXVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $175 | $3 | $178 | 0.16% |
| REBECCA SUZANNE RAMSEY3 | 1100 WEAVER PIKE BRISTOL, TN 37620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.04% |
| LISA JENNETTE UNDERHILL3 Filed as: LISA JEANNETTE UNDERHILL | 1296 RED OAK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.03% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK ROAD PLANT CITY, FL 33567 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| MARK CHRISTOPHER HOLLAND3 | PO BOX 389366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| RANDALL WAYNE WALLAXCW3 | 1204 RACHEL STREET SEVIERVILLE, TN 97876 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| GEORGE C SEYMOUR3 Filed as: GEORGE CHRISTOPHER SEYMOUR | 1428 PINEOLA AVENUE KINGSPORT, TN 37664 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| EAST TENNESSEE INSURANCE3 Filed as: EAST TENNESSEE INSURANCE AGENCY LLC | 801 SUNSET DRIVE BUILDING A #2 JOHNSON CITY, TN 37604 | USABLE LIFE | $193 | — | $193 | 9.91% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $90 | — | $90 | 4.62% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 111 | $1.1M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 111 | $1.1M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 111 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $112K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.