| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WESLEY BROWN | PO BOX 305025 NASHVILLE, TN 37230 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $58K | — | $58K | 3.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE | 265 BROOKVIEW CENTRE WAY KNOXVILLE, TN 37919 | DELTA DENTAL OF TENNESSEE | $13K | — | $13K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 26 CENTURY BLVD NASHVILLE, TN 37214 | HARTFORD LIFE AND ACCIDENT | $18K | — | $18K | 16.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 18101 VON KARMAN AVE SUITE 600 IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 5.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 806 TYVOLA RD SUITE 108 CHARLOTTE, NC 28217 | VISION SERVICE PLAN | $1K | — | $1K | 5.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | PRINCIPAL LIFE INSURANCE COMPANY | — | $302 | $302 | 103.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE | 26 CENTURY BLVD PO BOX 305025 NASHVILLE, TN 37230 | PRINCIPAL LIFE INSURANCE COMPANY | $53 | — | $53 | 18.09% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 421 | $1.5M |
| Dental | DELTA DENTAL OF TENNESSEE | 441 | $130K |
| Vision | VISION SERVICE PLAN | 187 | $23K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 190 | $110K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 190 | $110K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 190 | $110K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 421 | $1.5M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 190 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 441 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.