| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RYAN GROSE3 | 620 MABRY HOOD ROAD SUITE 201 KNOXVILLE, TN 37932 | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | $57K | — | $57K | 3.29% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | 500 W. 13TH STREET FORT WORTH, TX 76102 | HARTFORD LIFE AND ACCIDENT | $22K | — | $22K | 10.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | 500 W. 13TH STREET FORT WORTH, TX 76102 | DELTA DENTAL OF TENNESSEE | $5K | — | $5K | 6.00% |
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 | 288 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | 288 | $1.7M |
| Dental | DELTA DENTAL OF TENNESSEE | 301 | $90K |
| Vision | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | 288 | $1.7M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 257 | $216K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 257 | $216K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 257 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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."
No prospect flags tripped on this filing.