| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM THOMAS3 | TIS INS SER PO BOX 10328 KNOXVILLE, TN 37939 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $60K | — | $60K | 4.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SVCS INC | PO BOX 10328 KNOXVILLE, TN 37939 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | — | $19K | 9.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SVCS INC | PO BOX 10328 KNOXVILLE, TN 37939 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SVCS INC | PO BOX 10328 KNOXVILLE, TN 37939 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 20.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SVCS INC | PO BOX 10328 KNOXVILLE, TN 37939 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 20.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SVCS INC | PO BOX 10328 KNOXVILLE, TN 37939 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SVCS INC | PO BOX 10328 KNOXVILLE, TN 37939 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.27% |
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 | 392 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 392 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 392 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 8 | $208K |
| Life insurance(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 368 | $94K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 241 | $60K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 241 | $66K |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 368 | $362K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 392 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.