| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PHILIP C FREEMAN3 | 1945 SCOTTSVILLE RD STE 100 BOWLING GREEN, KY 42104 | BLUECROSS BLUESHIELD OF TENNESSE, INC. | $21K | — | $21K | 2.45% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 1945 SCOTTSVILLE RD STE 100 BOWLING GREEN, KY 42104 | SYMETRA LIFE INSURANCE COMPANY | $71K | $13K | $84K | 12.49% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 2305 RIVER ROAD LOUISVILLE, KY 40206 | RELIASTAR LIFE INSURANCE COMPANY | $37K | — | $37K | 27.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 62-0427913 BENEFIT ADMIN | Contract Administrator Service code 13 | — | $521K |
| PHILIP C FREEMAN AGENT | Insurance agents and brokers Service code 22 | 1945 SCOTTSVILLE ROAD STE 100 B BOWLING GREEN, KY 42104 | $75K |
| DELTA DENTAL OF OHIO EIN 31-0685339 BENEFIT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $28K |
| ASSUREDPARTNERS NL LLC AGENT | Insurance agents and brokers Service code 22 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | $0 |
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 | 936 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 32 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 974 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSE, INC. | 1,440 | $848K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSE, INC. | 1,440 | $848K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSE, INC. | 1,440 | $848K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 936 | $673K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 936 | $673K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 936 | $673K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 936 | $809K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,440 | — |
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.