| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COVERAGE SOLUTIONS GROUP3 | PO BOX 2198 HENDERSONVILLE, TN 37077 | USABLE LIFE | $8K | — | $8K | 15.00% |
| GROUP INSURANCE SERVICE INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $1K | — | $1K | 2.17% |
| COVERAGE SOLUTIONS GROUP3 | PO BOX 2198 HENDERSONVILLE, TN 37077 | USABLE LIFE | $7K | — | $7K | 15.00% |
| GROUP INSURANCE SERVICE INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $7K | — | $7K | 15.00% |
| FESMIRE, DAVID M3 | PO BOX 2198 HENDERSONVILLE, TN 37077 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 3.82% |
| GROUP INSURANCE SERVICE INC3 | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $1K | $175 | $1K | 14.57% |
| COVERAGE SOLUTIONS GROUP3 | PO BOX 2198 HENDERSONVILLE, TN 37077 | USABLE LIFE | $873 | — | $873 | 10.00% |
| GROUP INSURANCE SERVICE INC | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $744 | — | $744 | 15.00% |
| COVERAGE SOLUTIONS GROUP | PO BOX 2198 HENDERSONVILLE, TN 37077 | USABLE LIFE | $744 | — | $744 | 15.00% |
| DAVID S BIVINS3 Filed as: DAVID FESMIRE | PO BOX 2198 HENDERSONVILLE, TN 37077 | BLUECROSS OF TENNESSEE | $48K | — | $48K | — |
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 | 255 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS OF TENNESSEE | 255 | $0 |
| Dental | BLUECROSS OF TENNESSEE | 255 | $0 |
| Vision | BLUECROSS OF TENNESSEE | 255 | $0 |
| Life insurance(2 contracts) | USABLE LIFE | 221 | $58K |
| Short-term disability(2 contracts) | USABLE LIFE | 230 | $14K |
| Long-term disability(2 contracts, 2 carriers) | USABLE LIFE | 76 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.