| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDREW RADER3 | 265 BROOKVIEW CENTRE WAY SUITE 505 KNOXVILLE, TN 37919 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $67K | — | $67K | 2.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE - KNOXVILLE | 265 BROOKVIEW CENTRE WAY SUITE 505 KNOXVILLE, TN 37919 | DELTA DENTAL OF TENNESSEE | $9K | — | $9K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | PO BOX 19820 KNOXVILLE, TN 37939 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $3K | $10K | 9.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 806 TYVOLA RD SUITE 108 CHARLOTTE, NC 28217 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12K | — | $12K | 10.99% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN GRIFFIN | 2000 MORRIS AVE SUITE 1400 BIRMINGHAM, AL 35203 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $203 | — | $203 | 0.19% |
| DANIEL J WISTED3 | 3745 HEDGECLIFF COURT ALPHARETTA, GA 30022 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $46 | — | $46 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS O TENNESSEE, INC. | 806 TYVOLA RD SUITE 108 CHARLOTTE, NC 28217 | VISION SERVICE PLAN | $3K | — | $3K | 10.00% |
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 | 690 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 709 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 769 | $2.5M |
| Dental | DELTA DENTAL OF TENNESSEE | 801 | $170K |
| Vision | VISION SERVICE PLAN | 331 | $35K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 739 | $216K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 739 | $108K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 739 | $108K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 739 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 801 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.