| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE | 6322 DEANE HILL DR KNOXVILLE, TN 37919 | DELTA DENTAL OF TENNESSEE | $6K | — | $6K | 1.79% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | DELTA DENTAL OF TENNESSEE | $4K | — | $4K | 1.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PL CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | — | $16K | 6.99% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS INC TENNESSEE | 701 B ST 6TH FL SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 5.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 26 CENTURY BLVD 2ND FLOOR S NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 3.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PL CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | — | $12K | 7.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS INC TENNESSEE | 701 B ST 6TH FL SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 4.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 26 CENTURY BLVD 2ND FLOOR S. NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 3.83% |
| VARIOUS - SEE ATTACHED3 Filed as: MULTIPLE AGENTS-SEE ATTACHMENTS* | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $22K | $1K | $24K | 13.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PLACE CHICAGO, IL 60673 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.66% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 3.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PL CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 6.74% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS INC TENNESSEE | 701 B ST 6TH FL SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 26 CENTURY BLVD 2ND FLOOR S. NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PL CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS INC | TENNESSEE 701 B ST 6TH FL SAN ANTONIO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 26 CENTURY BLVD 2ND FLOOR S. NASHVILLE, TN 37214 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.53% |
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 | 1,043 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,056 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF TENNESSEE | 1,118 | $351K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 578 | $68K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 848 | $217K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 486 | $223K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 848 | $64K |
| Other(2 contracts, 2 carriers) | AFLAC | 848 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,118 | — |
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.