| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AERON J. LUCAS3 | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $170K | $0 | $170K | 3.01% |
| JILL DIETZE3 | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $14K | $0 | $14K | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 5910 TOOLE DRIVE KNOXVILLE, TN 37919 | HARTFORD LIFE AND ACCIDENT | $70K | $0 | $70K | 11.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD SUITE 14B CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $0 | $11K | $11K | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | DELTA DENTAL OF TENNESSEE | $22K | $0 | $22K | 5.00% |
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 | 993 | 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) | 995 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,059 | $5.6M |
| Dental | DELTA DENTAL OF TENNESSEE | 870 | $439K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,059 | $5.6M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 979 | $608K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 979 | $608K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 979 | $608K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 1,059 | $5.6M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 979 | $616K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,059 | — |
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."
No prospect flags tripped on this filing.