| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH LARSHUS3 | PO BOX 867 JOHNSON CITY, TN 37605 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $52K | — | $52K | 5.69% |
| PAUL COOK3 | PO BOX 669 GREENVILLE, TN 37744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 6.94% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DRIVE KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $693 | $3K | 4.00% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $456 | $2K | 2.91% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL ROAD SUITE 106 KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $871 | $52 | $923 | 1.09% |
| VICTORIA PAULIN3 | 172 SUNRISE DRIVE ELIZABETHTON, TN 37830 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $547 | — | $547 | 0.65% |
| MARGARET M GRAHAM3 | 200 CROOKED CREEK DRIVE ONEIDA, TN 37841 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $236 | $19 | $255 | 0.30% |
| VICTORIA L FLYNN3 | 7009 FAIRVIEW ROAD CORRYTON, TN 37721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $206 | — | $206 | 0.24% |
| ANDREW MURPHY3 | 4219 ALDERSHOT COURT D CHARLOTTE, NC 28211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $136 | — | $136 | 0.16% |
| NORMA J DAVIS3 | 269 RUFFIAN TRAIL CORBIN, KY 40701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.05% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH N MEACHAM | PO BOX 363 ANDERSONVILLE, TN 37705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| MARK HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| ELIZABETH LARSHUS3 Filed as: ELIZABETH LARSHUS C/O CAMBRON INSUR | PO BOX 867 JOHNSON CITY, TN 37604 | USABLE LIFE | $1K | — | $1K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $806 | $159 | $965 | 12.11% |
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 | 178 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 160 | $913K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 160 | $913K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 160 | $913K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 171 | $93K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 171 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.