| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KIMBERLEY BECK3 | 800 MAIN ST. DUBUQUE, ID 52004 | BLUERE OF TENNESSEE | $10K | — | $10K | 2.26% |
| GREGG B. LAWRENCE3 | 4100 CLOVER MEADOWS DRIVE FRANKLIN, TN 37067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30K | — | $30K | 7.99% |
| CRAIG GOODMAN LAWRENCE3 | 3326 ASPEN GROVE RD. NASHVILLE, TN 37067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25K | — | $25K | 6.58% |
| LERMAN VENTURES INC3 Filed as: LERMAN VENTURES, INC. | 2985 SURREY RIDGE RD. CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $444 | $4K | 1.04% |
| KAREN TOBIAS3 | 1366 DUNRAVEN DRIVE MURFREESBORO, TN 37128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $968 | — | $968 | 0.26% |
| AMY E COHEN3 Filed as: AMY C. WOLFE | 1024 GRANADA AVENUE NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $531 | $76 | $607 | 0.16% |
| CRAIG A. O'SHONEY3 | 4760 ST. ANDREW CT. CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $297 | — | $297 | 0.08% |
| ROBERT COLE3 | 115 LAKESIDE PARK CT. HENDERSONVILLE, TN 37079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $215 | — | $215 | 0.06% |
| KEITH TOBIAS3 | 1366 DUNRAVEN DRIVE MURFREESBORO, TN 37128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $180 | — | $180 | 0.05% |
| WESLEY ALLEN HUDNALL3 | 538 WESTWARD WINDS DR. NASHVILLE, TN 37221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $105 | $162 | 0.04% |
| MARK A SHELL3 Filed as: MARK A. SHELL | 413 MOSS TRAIL GOODLETTSVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | — | $152 | 0.04% |
| ANIMAL EMPIRE INC3 Filed as: ANIMAL EMPIRE, INC. | 1024 GRANADA AVENUE NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | — | $132 | 0.04% |
| MARK HOLLAND3 | P.O. BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.02% |
| BRENDA K COX3 Filed as: BRENDA K. COX | 3604 N. GRAND AVENUE CONNERSVILLE, IN 47331 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.01% |
| WILLIAM KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.00% |
| TODD BAKER3 | 380 HARDING PLACE NASHVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.00% |
| CATHY M LERMAN3 Filed as: CATHY M. LERMAN | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.00% |
| DEBORAH C BUSH3 Filed as: DEBORAH C. BUSH | 2962 BABY RUTH LANE ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| DANIELLE MORGAN3 | 27284 STRAWBERRY LANE, APT. 202 FARMINGTON HILLS, ME 48334 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| HEALTHMART USA3 | 3326 ASPEN GROVE DR. #270 FRANKLIN, TN 370674827 | AMERITAS LIFE INSURANCE CORP. | $27K | — | $27K | 8.00% |
| CRAIG A. O'SHONEY3 Filed as: CRAIG ALAN O'SHONEY | 4760 ST. ANDREW CT. CLARKSVILLE, TN 370437225 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 1.00% |
| CRAIG GOODMAN LAWRENCE3 | 3326 ASPEN GROVE DR., STE 270 FRANKLIN, TN 370674827 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 1.00% |
| HEALTHMART USA3 | 3326 ASPEN GROVE DR., STE 270 FRANKLIN, TN 37067 | SUN LIFE ASSURANCE COMPANY OF CANADA | $38K | — | $38K | 17.63% |
| CRAIG LAWRENCE3 | 1902 TURNING WHEEL LANE FRANKLIN, TN 37067 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 2.94% |
| CRAIG A. O'SHONEY3 Filed as: CRAIG O'SHONEY | 4760 ST. ANDREW CT. CLARKSVILLE, TN 37043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 2.03% |
| HEALTHSMART USA, LLC3 | 3326 ASPEN GROVE DR. SUITE 265 FRANKLIN, TN 37067 | UNITEDHEALTHCARE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| HEALTHMART USA3 Filed as: HEALTHMART, USA, LLC | 3326 ASPEN GROVE RD. STE. 270 FRANKLIN, TN 37067 | COMPANION LIFE | $3K | — | $3K | 6.38% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | ONE CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | COMPANION LIFE | $2K | — | $2K | 3.19% |
| HEALTHMART USA3 Filed as: HEALTHMART USA, LLC | 3326 ASPEN GROVE RD, STE. 270 FRANKLIN, TN 37067 | COMPANION LIFE | $4K | — | $4K | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | COMPANION LIFE | $2K | — | $2K | 7.50% |
| GREGG B. LAWRENCE3 | 4100 CLOVER MEADOWS DRIVE FRANKLIN, TN 37067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $433 | — | $433 | 4.39% |
| CRAIG GOODMAN LAWRENCE3 | 3327 ASPEN GROVE RD. NASHVILLE, TN 37067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $320 | $2 | $322 | 3.27% |
| LERMAN VENTURES INC3 Filed as: LERMAN VENTURES, INC. | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $3 | $72 | 0.73% |
| AMY E COHEN3 Filed as: AMY C. WOLFE | 1024 GRANADA AVE. NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.32% |
| KAREN TOBIAS3 | 1366 DUNRAVEN DR. MURFREESBORO, TN 37128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.27% |
| ANIMAL EMPIRE INC3 Filed as: ANIMAL EMPIRE, INC. | 1024 GRANADA AVENUE NASHVILLE, TN 37206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.17% |
| ROBERT COLE3 | 115 LAKESIDE PARK CT. HENDERSONVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.16% |
| MARK HOLLAND3 | P.O. BOX 38366 GERMANTOWN, TN 38183 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.10% |
| CRAIG A. O'SHONEY3 | 4760 ST. ANDREW CT. CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.04% |
| WESLEY ALLEN HUDNALL3 | 548 WESTGATE CT. NASHVILLE, TN 37221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| HEALTHMART USA3 | 3326 ASPEN GROVE DR, STE 270 FRANKLIN, TN 37067 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $703 | — | $703 | 12.97% |
| GOODMAN LAWRENCE CRAIG3 | 3326 ASPEN GROVE, STE. 270 FRANKLIN, TN 37067 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $88 | — | $88 | 1.62% |
| CRAIG A. O'SHONEY3 Filed as: CRAIG O'SHONEY | 4760 ST. ANDREWS COURT FRANKLIN, TN 37043 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $81 | — | $81 | 1.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD TN EIN 62-0427913 NONE | Contract Administrator Service code 13 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | $349K |
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 | 553 | 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) | 555 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUERE OF TENNESSEE | 1,160 | $531K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 1,731 | $341K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 1,731 | $341K |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE | 804 | $83K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 448 | $240K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 448 | $214K |
| Other(5 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 804 | $467K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,731 | — |
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.