| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIMOTHY RIEGER3 | 3931 S. DIXIE DRIVE DAYTON, OH 45439 | BLUECROSS BLUESHIELD OF TENNESSE, INC. | $17K | — | $17K | 1.11% |
| PHILIP C FREEMAN3 | 1945 SCOTTSVILLE RD STE 100 BOWLING, KY 42104 | BLUECROSS BLUESHIELD OF TENNESSE, INC. | $5K | — | $5K | 0.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S. DIXIE DR. DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $2K | $21K | 8.57% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $539 | $6K | 2.58% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S. DIXIE DR. DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $1K | $15K | 7.48% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $629 | $7K | 3.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY INC | 3931 S DIXIE DR DAYTON, OH 45439 | SUN LIFE ASSURANCE COMPANY OF CANADA | $16K | — | $16K | 11.68% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 6.46% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S. DIXIE DR. DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $498 | $8K | 11.47% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $197 | $3K | 4.86% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S. DIXIE DR. DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $399 | $4K | 9.31% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2305 RIVER ROAD STE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $761 | $73 | $834 | 1.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 BENEFIT ADMIN | Contract Administrator Service code 13 | — | $604K |
| DELTA DENTAL OF OHIO EIN 31-0685339 BENEFIT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $40K |
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 | 972 | 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) | 976 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSE, INC. | 1,907 | $1.6M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSE, INC. | 1,907 | $1.6M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSE, INC. | 1,907 | $1.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 679 | $244K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 81 | $197K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 83 | $69K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,276 | $432K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,907 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.