| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIMOTHY B WHITE3 | PO BOX 568 DICKSON, TN 37056 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | — | — | $0 | 0.00% |
| BENEFITS INC3 | 110 MATHIS DRIVE STE 106 DICKSON, TN 37055 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | — | $17K | 13.03% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 1.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFITS SYSTEMS INC EIN 36-3086057 | Plan Administrator Service code 14 | 200 WEST ADAMS ST SUITE 500 CHICAGO, IL 60606 | $13K |
| DIGITAL INSURANCE INC EIN 56-2522668 | Insurance brokerage commissions and fees Service code 53 | 200 GALLERIA PARKWAY, SE SUITE 1950 ATLANTA, GA 30339 | $8K |
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 | 143 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 143 | $620K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $134K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $134K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $134K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $134K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $134K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 49 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.