| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN GREENBAUM3 | 160 FEDERAL ST BOSTON, MA 02110 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $109K | $0 | $109K | 5.73% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $8K | $0 | $8K | 3.02% |
| SELMAN & COMPANY, LLC3 | ONE INTEGRITY PARKWAY CLEVELAND, OH 44143 | RELIANCE STANDARD | $5K | $0 | $5K | 1.98% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $4K | $0 | $4K | 1.69% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $5K | $0 | $5K | 7.44% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $2K | $0 | $2K | 2.79% |
| SELMAN & COMPANY, LLC3 | ONE INTEGRITY PARKWAY CLEVELAND, OH 44143 | RELIANCE STANDARD | $2K | $0 | $2K | 2.21% |
| RSC INSURANCE BROKERAGE INC3 | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $3K | $0 | $3K | 7.83% |
| SELMAN & COMPANY, LLC3 | ONE INTEGRITY PARKWAY CLEVELAND, OH 44143 | RELIANCE STANDARD | $1K | $0 | $1K | 2.67% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $988 | $0 | $988 | 2.33% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANC BROKERAGE, INC. | 750 THIRD AVENUE STE 1500 NEW YORK, NY 10017 | RELIANCE STANDARD | $390 | $0 | $390 | 14.99% |
| SELMAN & COMPANY, LLC3 | ONE INTEGRITY PARKWAY CLEVELAND, OH 44143 | RELIANCE STANDARD | $69 | $0 | $69 | 2.65% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W VEVA 16 BLUE BELL, PA 19422 | RELIANCE STANDARD | $61 | $0 | $61 | 2.35% |
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 | 212 | 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) | 212 | 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 | 212 | $263K |
| Short-term disability | RELIANCE STANDARD | 71 | $42K |
| Long-term disability | RELIANCE STANDARD | 118 | $72K |
| Other(2 contracts) | RELIANCE STANDARD | 212 | $266K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.