| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL ROBERSON3 | 2670 UNION AVE STE 100 MEMPHIS, TN 38112 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $41K | — | $41K | 5.72% |
| LIPSCOMB & PITTS INSURANCE LLC3 Filed as: LIPSCOMB & PITTS INS | 2670 UNION AVE EXT 200 MEMPHIS, TN 38112 | GUARDIAN | $5K | $3K | $8K | 10.29% |
| GROUP INSURANCE SERVICES INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $7K | — | $7K | 15.00% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVE STE 200 MEMPHIS, TN 38112 | USABLE LIFE | $7K | — | $7K | 15.00% |
| DEBORAH SUSAN RIFFLE3 | 129 JIM BOB SCRUGGS RD HUMBOLDT, TN 38343 | AFLAC | $2K | — | $2K | 11.86% |
| VICKI LYNN HILL3 | 130 WESTWIND DR MEDINA, TN 38355 | AFLAC | $2K | $77 | $2K | 9.23% |
| DARIAN NULL3 | 248 GROOM AVE COVINGTON, TN 38019 | AFLAC | $929 | $15 | $944 | 5.09% |
| CHARLES HARTHUN3 | 1577 LAWSON RD CROSSVILLE, TN 38571 | AFLAC | $553 | $15 | $568 | 3.06% |
| ELIZABETH KATHLEEN SIKES3 | 352 HAWTHORNE RIDGE CIR DALLAS, GA 30132 | AFLAC | $196 | — | $196 | 1.06% |
| ARTHUR M PRIDDY3 | 214 LIBERTY RD JACKSON, TN 38305 | AFLAC | $103 | — | $103 | 0.56% |
| KATHRYN SUZANNE AXENTE3 | 500 N WEST SHORE BLVD STE 1015 TAMPA, FL 33609 | AFLAC | $46 | — | $46 | 0.25% |
| ROBERT GOBLE3 | 1410 4T STREET DR NW UNIT 208 HICKORY, NC 28601 | AFLAC | $28 | — | $28 | 0.15% |
| JOSHUA LEE JONES3 | 18032 DEERCLIFF CT GLENCOE, MO 63038 | AFLAC | $26 | — | $26 | 0.14% |
| ELIZABETH KATHLEEN SIKES3 | 4493 DUNMOVIN DR NW KENNESAW, GA 30144 | AFLAC | $18 | — | $18 | 0.10% |
| NATHAN A JONES3 | 406 S STRADLING RD MUNCIE, IN 47304 | AFLAC | $15 | — | $15 | 0.08% |
| VBTN, INC3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $14 | — | $14 | 0.08% |
| BRENT GOODE3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $12 | — | $12 | 0.06% |
| ARTHUR PRIDDY3 | 436 W GRAND ST JACKSON, TN 38301 | AFLAC | $10 | — | $10 | 0.05% |
| JAY OLEARY3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $1 | — | $1 | 0.01% |
| KIMBERLY MURRAY3 | 8530 WOODLANE DR GERMANTOWN, TN 38138 | AFLAC | $1 | — | $1 | 0.01% |
| AMY B CITRON3 Filed as: AMY CITRON | 1024 GRANADA AVE NASHVILLE, TN 37206 | AFLAC | $1 | — | $1 | 0.01% |
| ALAN W MARTIN3 Filed as: ALAN MARTIN | 12524 MALLARD BAY DR KNOXVILLE, TN 37922 | AFLAC | $1 | — | $1 | 0.01% |
| JOANNA G MATHERLY3 Filed as: JOANNA MATHERLY | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $1 | — | $1 | 0.01% |
| MP JONES & ASSOCIATES3 | 13846 ATLANTIC BLVD APT 101 JACKSONVILLE, FL 32225 | AFLAC | $1 | — | $1 | 0.01% |
| TAMI S GILL3 Filed as: TAMI GILL | 53 MICHELLE DR BRIGHTON, TN 38011 | AFLAC | $1 | — | $1 | 0.01% |
| JOSEPH LEDOUX3 | 2411 CARTER AVE NASHVILLE, TN 37206 | AFLAC | $1 | — | $1 | 0.01% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 133 | $82K |
| Vision | GUARDIAN | 133 | $82K |
| Life insurance | GUARDIAN | 133 | $82K |
| Other | USABLE LIFE | 49 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.