| 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. | $33K | — | $33K | 3.17% |
| PAUL COOK3 | PO BOX 669 GREENVILLE, TN 37744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 5.88% |
| JM TAMER & CO3 | 6500 PAPERMILL DRIVE SUITE 201 KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $526 | $4K | 3.33% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL DRIVE SUITE 201 KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $285 | $3K | 2.78% |
| SUSAN FONTANA FLYNN3 | 8814 EAGLE POINTE DRIVE KNOXVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $831 | $33 | $864 | 0.78% |
| MARY DAUGHERTY3 | PO BOX 119 ROCKY TOP, TN 37769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $571 | — | $571 | 0.52% |
| VICTORIA L FLYNN3 | 7009 FAIRVIEW ROAD CORRYTON, TN 37721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $509 | $50 | $559 | 0.51% |
| REBECCA SUZANNE RAMSEY3 | 1100 WEAVER PIKE BRISTOL, TN 37620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $328 | $32 | $360 | 0.33% |
| LISA JENNETTE UNDERHILL3 | 1296 RED OAK DRIVE BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | — | $100 | 0.09% |
| RANDALL WAYNE WALLAXCW3 | 1204 RACHEL STREET SEVIERVILLE, TN 97876 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $32 | $57 | 0.05% |
| ANNALEA TAMER EDWARDS3 | 5217 BUCKHEAD TRAIL KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.05% |
| GEORGE C SEYMOUR3 Filed as: GEORGE CHRISTOPHER SEYMOUR | 1428 PINEOLA AVENUE KINGSPORT, TN 37664 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.02% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK ROAD PLANT CITY, FL 33567 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.02% |
| DEBBIE RENEA CUNNINGHAM3 | 3764 CALISTA ROAD CROSS PLAINS, TN 37049 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| MARK CHRISTOPHER HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| EAST TENNESSEE INSURANCE3 Filed as: EAST TENNESSEE INSURANCE AGENCY LLC | 801 SUNSET DRIVE BUILDING A #2 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 | $729 | $157 | $886 | 11.26% |
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 | 110 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 110 | $1.0M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 110 | $1.0M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 110 | $1.0M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $118K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $118K |
| 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.