| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FREDERICH C SCHAEFFER3 | PO BOX 171368 MEMPHIS, TN 38120 | BLUERE OF TENNESSEE | $98K | — | $98K | 6.55% |
| FREDERICK C SCHAEFFER3 | 949 SHADY GROVE RD S STE 300 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $35K | $0 | $35K | 5.38% |
| STRATEGIC FINANCIAL PARTNERS3 | 949 SHADY GROVE RD S STE 300 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $35K | $0 | $35K | 5.38% |
| DIANE STEVENS NIESEN3 | 2121 TARYN LN NESBIT, MS 38651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $498 | $0 | $498 | 1.54% |
| JOSEPH L GREENE3 | 3597 GREENSIDE DR APT 103 MEMPHIS, TN 38125 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $365 | $0 | $365 | 1.13% |
| INSURANCE CONSULTING GROUP INC3 | 4735 SPOTTSWOOD MEMPHIS, TN 38117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $341 | $0 | $341 | 1.05% |
| FREDERICK C SCHAEFFER3 | PO BOX 171368 MEMPHIS, TN 38120 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $338 | $0 | $338 | 1.04% |
| SFPW INC3 | 795 RIDGE LAKE BLVD MEMPHIS, TN 38120 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $135 | $0 | $135 | 0.42% |
| KENNETH CARPENTER3 | 671 WHEATLEY CV COLLIERVILLE, TN 38017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $0 | $63 | 0.19% |
| INSPIRED INC3 | 50 LAGOSHEN DR MOSCOW, TN 38057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $19 | $51 | 0.16% |
| JOHN R JOHN3 | 6240 POPLAR AVE MEMPHIS, TN 38119 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $1 | $32 | 0.10% |
| JOSEPH STERLING SHEPPARD3 | C/O JOSEPH STERLING SHEPPARD CORDOVA, TN 38018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.09% |
| BENEFIT ENROLLMENT SERVICES INC3 | 210 CARDEN AVE NASHVILLE, TN 37205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.06% |
| DAVID EVANS3 | 2711 YORK CT SOUTHLAKE, TX 76092 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.05% |
| DENNIS E TRAYWICK3 | 1325 BLACK RD PROSPECT, TN 38477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.02% |
| SALLY E STARK3 | 305 DIANNE CIR BOSSIER CITY, LA 71111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| DIANE STEVENS NIESEN3 | 2121 TARYN LN NESBIT, MS 38651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $733 | $0 | $733 | 2.39% |
| INSURANCE CONSULTING GROUP INC3 | 4735 SPOTTSWOOD MEMPHIS, TN 38117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $353 | $0 | $353 | 1.15% |
| FREDERICK C SCHAEFFER3 | PO BOX 171368 MEMPHIS, TN 38187 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $353 | $0 | $353 | 1.15% |
| JOSEPH L GREENE3 | 3597 GREENSIDE DR APT 103 MEMPHIS, TN 38125 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $182 | $0 | $182 | 0.59% |
| INSPIRED INC3 | 50 LAGOSHEN DR MOSCOW, TN 38057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $41 | $110 | 0.36% |
| SFPW INC3 | 795 RIDGE LAKE BLVD MEMPHIS, TN 38120 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | $0 | $104 | 0.34% |
| JOHN R JOHN3 | 6240 POPLAR AVE MEMPHIS, TN 38119 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $2 | $57 | 0.19% |
| JOSEPH STERLING SHEPPARD3 | C/O JOSEPH STERLING SHEPPARD CORDOVA, TN 38018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.10% |
| BENEFIT ENROLLMENT SERVICES INC3 | 210 CARDEN AVE NASHVILLE, TN 37205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 0.08% |
| KENNETH CARPENTER3 | 671 WHEATLEY CV COLLIERVILLE, TN 38017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.06% |
| DENNIS E TRAYWICK3 | 1325 BLACK RD PROSPECT, TN 38477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.03% |
| DAVID EVANS3 | 2711 YORK CT SOUTHLAKE, TX 76092 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| FREDERICK C SCHAEFFER3 | PO BOX 171368 MEMPHIS, TN 38120 | BLUECROSS BLUESHIELD OF TENNESSEE INC | $955 | — | $955 | 9.93% |
| 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 | $466K |
| FREDERICK C SCHAEFFER EIN 26-0427913 AGENT/BROKER | Contract Administrator Service code 13 | PO BOX 171368 MEMPHIS, TN 38120 | $29K |
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 | 1,403 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUERE OF TENNESSEE | 1,403 | $1.5M |
| Dental | BLUERE OF TENNESSEE | 1,403 | $1.5M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE INC | 1,401 | $10K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 755 | $714K |
| Short-term disability(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 755 | $714K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 755 | $651K |
| Prescription drug | BLUERE OF TENNESSEE | 1,403 | $1.5M |
| Stop-loss / reinsurancereinsurance | BLUERE OF TENNESSEE | 1,403 | $1.5M |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 755 | $714K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,403 | — |
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.