| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $76K | — | $76K | 6.13% |
| HENRY VALENTINE LINDEMAN II3 Filed as: HENRY LINDMAN | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $30K | — | $30K | 3.22% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44K | — | $44K | 6.10% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 555 PERKINS EXT SUITE 330 MEMPHIS, TN 38117 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | — | $28K | 5.00% |
| RBH INSURE3 | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $64K | $19K | $83K | 19.84% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $64K | $1K | $65K | 15.64% |
| RBH INSURE3 | 555 PERKINS EXT MEMPHIS, TN 38117 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.33% |
| RBH INSURE3 | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $42K | $13K | $55K | 19.72% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $42K | $583 | $43K | 15.38% |
| RBH INSURE3 | 555 PERKINS EXT MEMPHIS, TN 38117 | METROPOLITAN LIFE INSURANCE COMPANY | — | $583 | $583 | 0.21% |
| RBH INSURE3 | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $42K | $11K | $54K | 21.61% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN LIFE INSURANCE COMPANY | $42K | $405 | $43K | 17.27% |
| RBH INSURE3 | 555 PERKINS EXT MEMPHIS, TN 38117 | METROPOLITAN LIFE INSURANCE COMPANY | — | $407 | $407 | 0.16% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 20.00% |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 555 PERKINS EXTENDED SUITE 330 MEMPHIS, TN 38117 | HARTFORD FIRE INSURANCE COMPANY | $529 | — | $529 | 15.01% |
| RBH INSURE3 | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN TOWER LIFE INSURANCE COMPANY | $10K | $2K | $11K | — |
| VALENTINE INSURANCE SERVICES, LLC3 Filed as: VALENTINE INSURANCE SERVICES LLC | 825 VALLEYBROOK DRIVE SUITE 101 MEMPHIS, TN 38120 | METROPOLITAN TOWER LIFE INSURANCE COMPANY | $10K | $247 | $10K | — |
| RBH INSURE3 | 555 PERKINS EXT MEMPHIS, TN 38117 | METROPOLITAN TOWER LIFE INSURANCE COMPANY | — | $246 | $246 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH SOLUTIONS LLC EIN 39-1997579 CONTRACT ADMIN. | Contract Administrator Service code 13 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | $655K |
| NARUS HEALTH INC. EIN 47-1929604 OTHER | Other fees Service code 99 | 424 CHURCH STREET SUITE 2300 NASHVILLE, TN 37219 | $655K |
| VALENTINE INSURANCE SERVICES EIN 83-0923712 BROKER | Insurance agents and brokers Service code 22 | 825 VALLEYBROOK ROAD SUITE 101 MEMPHIS, TN 38119 | $443K |
| MULTIPLAN NONE | Other fees Service code 99 | PO BOX 29380 NEW YORK, NY 10087 | $373K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 CLAIMS PROCESSING | Claims processing Service code 12 | — | $219K |
| SELERIX SYSTEMS INC EIN 80-0236699 OTHER | Other fees Service code 99 | PO BOX 678967 DALLAS, TX 75267 | $193K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 NONE | Other fees Service code 99 | — | $158K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 OTHER | Other fees Service code 99 | — | $127K |
| AMERICAN HEALTH HOLDINGS EIN 31-1368946 OTHER | Other fees Service code 99 | PO BOX 360142 PITTSBURGH, PA 15250 | $62K |
| SELERIX SYSTEMS INC. EIN 80-0236699 BROKER | Insurance agents and brokers Service code 22 | — | $22K |
| CAREOPERATIVE LLC EIN 46-4399706 NONE | Other fees Service code 99 | 330 FRANKLIN ROAD SUITE 135A-42B BRENTWOOD, TN 37027 | $19K |
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 | 7,425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 191 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,643 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 5 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 2,209 | $4.6M |
| Vision | VISION SERVICE PLAN | 3,403 | $282K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 7,134 | $722K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 7,563 | $1.2M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 158 | $935K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 3,457 | $3.2M |
| Other(6 contracts, 6 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 8,161 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,161 | — |
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.