| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH AMERICA ADMINISTRATORS, LP5 | 1826 ELM HILL PIKE NASHVILLE, TN 37210 | SIRIUS AMERICA INSURANCE COMPANY | $43K | — | $43K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH SOLUTIONS , LLC EIN 47-1931003 | Other fees Service code 99 | 424 CHURCH ST. SUITE 2300 NASHVILLE, TN 37219 | $116K |
| CIGNA EIN 59-1031071 | Other fees Service code 99 | PO BOX 645014 CINCINNATI, OH 452645014 | $56K |
| HOUCHENS INSURANCE GROUP, INC. EIN 20-5190385 | Other fees Service code 99 | 1750 SCOTTSVILLE RD. SUITE 4 BOWLING GREEN, KY 42101 | $37K |
| RANDY OWEN AGENCY EIN 40-9800709 | Other fees Service code 99 | 101 SOUTHSIDE SQUARE SHELBYVILLE, TN 37160 | $37K |
| QUEST DIAGNOSTICS, INC. | Other fees Service code 99 | PO BOX 740709 ATLANTA, GA 303740709 | $3K |
| MES PEER REVIEW SERVICES EIN 38-2193020 | Other fees Service code 99 | 100 MORSE ST. NORWOOD, MA 02062 | $265 |
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 | 299 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIRIUS AMERICA INSURANCE COMPANY | 299 | $0 |
| Dental | SIRIUS AMERICA INSURANCE COMPANY | 299 | $0 |
| Prescription drug | SIRIUS AMERICA INSURANCE COMPANY | 299 | $0 |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 299 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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."
No prospect flags tripped on this filing.