| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BOULEVARD PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $22K | — | $22K | 3.69% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN INC | 721 S PARKER SUITE 300 ORANGE, CA 92868 | AETNA LIFE INSURANCE CO. | $5K | — | $5K | 0.92% |
| HENRY VALENTINE LINDEMAN II3 Filed as: HENRY LINDMAN | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $11K | — | $11K | 2.16% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICE LLC | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40K | $3K | $42K | 10.65% |
| BENEFIT COMMUNICATIONS INC3 | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $4K | $33K | 8.39% |
| RBH INSURE3 | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33K | — | $33K | 8.21% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP INC | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.67% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL SUITE 200 MEMPHIS, TN 38117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.29% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 5.77% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $32K | $1K | $33K | 34.44% |
| BENEFIT COMMUNICATIONS INC3 | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $441 | $5K | 5.74% |
| RBH INSURE3 | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 4.79% |
| HENRY VALENTINE LINDEMAN II3 Filed as: HENRY VALENTINE LINDEMAN | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38137 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.35% |
| JAS D COLLIER & CO3 | 606 S MENDENHALL SUITE 200 MEMPHIS, TN 38117 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $164 | — | $164 | 0.17% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY 80 SUITE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $152 | — | $152 | 0.16% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP INC | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $138 | — | $138 | 0.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH SOLUTIONS EIN 39-1997579 CONTRACT ADMIN. | Claims processing Service code 12 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | $399K |
| NARUS HEALTH EIN 47-1929604 OTHER | Other fees Service code 99 | 424 CHURCH STREET SUITE 2300 NASHVILLE, TN 37219 | $274K |
| VALENTINE INSURANCE SERVICES EIN 83-0923712 INSURANCE AGENCY | Custodial (securities) Service code 19 | 555 PERKIN EXTENDED SUITE 330 MEMPHIS, TN 38117 | $242K |
| HST TECHNOLOGY SOLUTIONS EIN 27-1818792 OTHER | Other fees Service code 99 | 3857 BIRCH STREET SUITE 586 NEWPORT BEACH, CA 92660 | $177K |
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 NONE | Other fees Service code 99 | — | $76K |
| HEALTHEOS BY MULTIPLAN INC EIN 39-1634080 OTHER | Other fees Service code 99 | PO BOX 29380 NEW YORK, NY 10087 | $72K |
| SELERIX SYSTEMS INC EIN 80-0236699 OTHER | Other fees Service code 99 | PO BOX 678967 DALLAS, TX 75267 | $63K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 OTHER | Other fees Service code 99 | PO BOX 360142 PITTSBURGH, PA 15250 | $29K |
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 | 5,797 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 184 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,023 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 5 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 6,081 | $2.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 94 | $512K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,078 | $674K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,424 | $404K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,425 | $492K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 94 | $512K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE OF COLUMBIA SC | 1,805 | $934K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,428 | $801K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,081 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.