| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS STUBBS3 | 4823 OLD KINGSTON PIKE STE 205 KNOXVILLE, TN 37919 | BLUE CROSS BLUE SHIELD OF TENNESSEE | $31K | $0 | $31K | 11.75% |
| CINDY L HANNA3 | 268 VALLEY VIEW DR NEWPORT, TN 37821 | AFLAC | $5K | $141 | $5K | 5.33% |
| CINDY L HANNA3 | 1177 GOLF COURSE RD NEWPORT, TN 37821 | AFLAC | $4K | $112 | $5K | 4.68% |
| JACKSON D RHODES3 | 525 W OAKLAND AVE STE 7 JOHNSON CITY, TN 37604 | AFLAC | $2K | $87 | $2K | 1.92% |
| EMMETT HAWKINS3 Filed as: EMMETT M HAWKINS | PO BOX 322 ABINGDON, VA 24212 | AFLAC | $2K | $26 | $2K | 1.59% |
| JAMES E GOLDRICK3 | 3467 HARDWOOD DR MURFREESBORO, TN 37129 | AFLAC | $1K | $0 | $1K | 1.37% |
| LYNN HODGE3 | 32 EARHART RD BLUFF CITY, TN 37618 | AFLAC | $1K | $0 | $1K | 1.06% |
| WANDA STEPP3 | 4720 FOWLER DRIVE MORRISTOWN, TN 37814 | AFLAC | $1K | $0 | $1K | 1.02% |
| LARRY D KINSLER3 | 106 PICADILLY LN JOHNSON CITY, TN 37615 | AFLAC | $763 | $0 | $763 | 0.78% |
| JAMES C FARMER JR3 | 641 OLD HICKORY BLVD UNIT 60 BRENTWOOD, TN 37027 | AFLAC | $694 | $61 | $755 | 0.77% |
| BETH MORROW3 | 4700 STAPLETON RD MORRISTOWN, TN 37813 | AFLAC | $514 | $0 | $514 | 0.52% |
| VBTN, INC3 | 301 MALLORY STATION RD STE 100 FRANKLIN, TN 37067 | AFLAC | $158 | $87 | $245 | 0.25% |
| BRENT L GOODE3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $243 | $0 | $243 | 0.25% |
| CHARLES F GREER3 | 2888 ALOMA LAKE RUN OVIEDO, FL 32765 | AFLAC | $236 | $0 | $236 | 0.24% |
| TERRI L LAWSON DRAKE3 | 1009 PAINTER CREEK RD BRISTOL, TN 37601 | AFLAC | $138 | $79 | $217 | 0.22% |
| RUTH HOBBS FARMER3 | 641 OLD HICKORY BLVD UNIT 60 BRENTWOOD, TN 37027 | AFLAC | $119 | $24 | $143 | 0.15% |
| ABBIE W COFFMAN3 | 31 HAWTHORN CIR CROSSVILLE, TN 38555 | AFLAC | $80 | $0 | $80 | 0.08% |
| JAMES C FARMER JR3 Filed as: JAMES CHARGES FARMER III | 641 OLD HICKORY BLVD UNIT 60 BRENTWOOD, TN 37027 | AFLAC | $49 | $0 | $49 | 0.05% |
| JERRI A SURBER3 | 813 WEDGEWOOD RD SUITE 2300 JOHNSON CITY, TN 37604 | AFLAC | $44 | $0 | $44 | 0.04% |
| JOSHUA CLAYTON3 | 627 CHARLIE HICKS RD JONESBOROUGH, TN 37659 | AFLAC | $42 | $0 | $42 | 0.04% |
| SAMUEL ANDERSON3 Filed as: SAMUEL G ANDERSON | 191 CHEROKEE STREET SURGOINSVILLE, TN 37873 | AFLAC | $41 | $0 | $41 | 0.04% |
| RONALD H RICHEY3 | 4023 LAURAWOOD LN FRANKLIN, TX 37067 | AFLAC | $39 | $0 | $39 | 0.04% |
| MATTHEW SMITH3 Filed as: MATTHEW A SMITH | 218 HERMITAGE BLVD STE 203 OAK RIDGE, TN 37830 | AFLAC | $38 | $0 | $38 | 0.04% |
| ALAN W MARTIN3 | 123 CENTER PARK DR SUITE 102 KNOXVILLE, TN 37922 | AFLAC | $38 | $0 | $38 | 0.04% |
| JOSHUA CLAYTON3 | 627 CHARLIE HICKS RD JONESBOROUGH, TN 37659 | AFLAC | $35 | $0 | $35 | 0.04% |
| SANDRA FIELDS3 Filed as: SANDRA D FIELDS | 246 AESQUE ST EXT KINGSPORT, TN 37665 | AFLAC | $31 | $0 | $31 | 0.03% |
| GARY STORY3 Filed as: GARY A STORY | PO BOX 4328 CRS JOHNSON CITY, TN 37602 | AFLAC | $28 | $0 | $28 | 0.03% |
| KENNETH R MEREDITH3 | PO BOX 13 2113 WEATHERFORD CREEK ROAD LUTTS, TN 38471 | AFLAC | $22 | $0 | $22 | 0.02% |
| RONALD E KIRKLAND3 | 4 SOTHEBY PL SE GURLEY, AL 35748 | AFLAC | $19 | $0 | $19 | 0.02% |
| CLIFF STEPP3 | 4720 FOWLER DR MORRISTOWN, TN 37814 | AFLAC | $16 | $0 | $16 | 0.02% |
| DAVID R CHARLES3 | 214 WINDRIDGE COLONY STE 403 JOHNSON CITY, TN 37601 | AFLAC | $15 | $0 | $15 | 0.02% |
| FREDERICK HARRIS JR3 Filed as: FREDERICK L HARRIS JR | 802 BUFFALO ST SUITE 14 JOHNSON CITY, TN 37604 | AFLAC | $8 | $0 | $8 | 0.01% |
| BRIAN BROYLES3 | 913 TUSCULUM BLVD GREENEVILLE, TN 37745 | AFLAC | $7 | $0 | $7 | 0.01% |
| GEORGE C SEYMOUR3 | 202 AZALEA RIDGE JOHNSON CITY, TN 37601 | AFLAC | $2 | $0 | $2 | 0.00% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE STE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $5K | $18K | 20.48% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE STE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 20.47% |
| TRINITY BENEFIT ADVISORS, INC.3 Filed as: TRINITY BENEFIT ADVISORS | 4823 OLD KINGSTON PIKE STE 205 KNOXVILLE, TN 37919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 26.71% |
| THOMAS STUBBS3 | 4823 OLD KINGSTON PIKE STE 205 KNOXVILLE, TN 37919 | BLUE CROSS BLUE SHIELD OF TENNESSEE | $4K | $0 | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 62-0427913 ADMINISTRATOR | Contract Administrator Service code 13 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | $136K |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF TENNESSEE | 403 | $262K |
| Dental | BLUE CROSS BLUE SHIELD OF TENNESSEE | 319 | $0 |
| Vision | BLUE CROSS BLUE SHIELD OF TENNESSEE | 403 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 191 | $59K |
| Short-term disability | AFLAC | 174 | $98K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 191 | $86K |
| Other(2 contracts, 2 carriers) | AFLAC | 191 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 403 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.