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| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | $333K |
| FREDERICK C SCHAEFFER EIN 62-0427913 AGENT/BROKER | Consulting (pension) Service code 17 | PO BOX 171368 MEMPHIS, TN 38120 | $5K |
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 | 1,159 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUERE OF TENNESSEE | 1,159 | $1.1M |
| Dental | BLUERE OF TENNESSEE | 1,159 | $1.1M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE INC | 1,159 | $89K |
| Life insurance(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 557 | $482K |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 557 | $482K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 557 | $397K |
| Stop-loss / reinsurancereinsurance | BLUERE OF TENNESSEE | 1,159 | $1.1M |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 557 | $482K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,159 | — |
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.