| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH LARSHUS3 | P.O. BOX 867 JOHNSON CITY, TN 37605 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $56K | — | $56K | 5.75% |
| PAUL COOK3 | PO BOX 669 GREENVILLE, TN 37744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 6.00% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DRIVE KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $497 | $3K | 3.33% |
| MARY DAUGHERTY3 | 7625 STAR GAZING LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $172 | $2K | 1.75% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL ROAD SUITE 106 KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $135 | $1K | 1.71% |
| LISA JENNETTE UNDERHILL3 | 1296 RED OAK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $344 | $24 | $368 | 0.42% |
| DEBBIE RENEA CUNNINGHAM3 | 4006 WINDSONG TRAIL GREENBRIER, TN 37073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $318 | $8 | $326 | 0.37% |
| PAULA HARGIS3 | 101 WESLEY ROAD LENOIR CITY, TN 37772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $162 | $8 | $170 | 0.19% |
| VICTORIA L FLYNN3 | 7009 FAIRVIEW ROAD CORRYTON, TN 37721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $160 | — | $160 | 0.18% |
| SHEILA A SHELL3 | 413 MOSS TRAIL GOODLETTSVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $2 | $77 | 0.09% |
| LVL BENEFITS SERVICES LLC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | $20 | $68 | 0.08% |
| DEBBIE PERKINS3 | 9655 BRUNSWICK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | $15 | $67 | 0.08% |
| MARGARET M GRAHAM3 | 200 CROOKED CREEK DRIVE ONEIDA, TN 37841 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.05% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK ROAD PLANT CITY, FL 33567 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.05% |
| NORMA J DAVIS3 | 269 RUFFIAN TRAIL CORBIN, KY 40701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| MARK CHRISTOPHER 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 | P.O. BOX 867 JOHNSON CITY, TN 37604 | USABLE LIFE | $1K | — | $1K | 14.99% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $632 | $137 | $769 | 11.23% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 154 | $983K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 154 | $983K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 154 | $983K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 157 | $94K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 157 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.