| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN GREENBAUM3 | 160 FEDERAL ST BOSTON, MA 02110 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $0 | $110K | $110K | 5.76% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $4K | $0 | $4K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $3K | $0 | $3K | 4.01% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $3K | $0 | $3K | 8.47% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $2K | $0 | $2K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $4K | $0 | $4K | 11.01% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $2K | $0 | $2K | 5.00% |
| EPSIX, INC.3 Filed as: EPSIX, INC | 3300 N SCOTTSDALE RD APT 4020 SCOTTSDALE, AZ 85251 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 6.57% |
| GIANA M COURT3 | 544 VAN BUREN ST. APT 1 BROOKLYN, NY 11221 | CONTINENTAL AMERICAN INSURANCE COMPANY | $288 | $0 | $288 | 1.67% |
| CHARLEEN A WRIGHT3 | 2565 ALLEGHANY LOOP VIRGINIA BEACH, VA 23456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $135 | $0 | $135 | 0.78% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: ELMER BROWN | 212 EAST 112TH ST. APT 1 NEW YORK, NY 10029 | CONTINENTAL AMERICAN INSURANCE COMPANY | $83 | $0 | $83 | 0.48% |
| GEORGE B WEILER3 | 3300 N SCOTTSDALE RD APT 4020 SCOTTSDALE, AZ 85251 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | $0 | $28 | 0.16% |
| ANGELA MONTENEGRO3 | 74 HILLANALE DRIVE NEW ROCHELLE, NY 10804 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | $0 | $8 | 0.05% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST 2ND FLOOR BOSTON, MA 02110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | $0 | $93 | 1.73% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 400 POST AVE STE 210 WESTBURY, NY 11590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $0 | $59 | 1.10% |
| MARY DAUGHERTY3 Filed as: MARY DAUHERTY | PO BOX 119 ROCKY TOP, TN 37769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $54 | $54 | 1.00% |
| MCO PARTNERS LLC3 | 6 LATHROP AVE UNIT B MADISON, NJ 07940 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $42 | $42 | 0.78% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES M CUNNINGHAM | 1213 GETTYSVUE WAY KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $35 | $35 | 0.65% |
| JM TAMER & CO3 | 6500 PAPERMILL DR STE 201 KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 0.65% |
| YOLANDA TRISTANCHO-HELWIG3 | 315 W 39TH ST RM 303 NEW YORK, NY 10018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.37% |
| CURTIS E SHOEMAKER JR3 | 7712 CEDARCREST RD KNOXVILLE, TN 37918 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.33% |
| DEBORAH PADGETT GREENWELL3 | 429 ASHLEY AVE PIGEON FORGE, TN 37863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.19% |
| MARK CHRISTOPHER HOLLAND3 | PO BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.06% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANC BROKERAGE, INC. | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $337 | $0 | $337 | 15.02% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $112 | $0 | $112 | 4.99% |
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 166 | $1.9M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 166 | $1.9M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 166 | $1.9M |
| Life insurance | RELIANCE STANDARD | 210 | $85K |
| Short-term disability(3 contracts, 3 carriers) | RELIANCE STANDARD | 161 | $57K |
| Long-term disability | RELIANCE STANDARD | 130 | $33K |
| Other(4 contracts, 3 carriers) | RELIANCE STANDARD | 210 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.