| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER WITHEROW & ASSOC3 Filed as: ROGER WITHEROW AND ASSOCIATES INC | 1517 HATCHER LANE COLUMBIA, TN 38401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $1K | $21K | 21.07% |
| ROGER WITHEROW & ASSOC3 Filed as: ROGER WITHEROW AND ASSOCIATES INC | 1517 HATCHER LANE COLUMBIA, TN 38401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $625 | $12K | 21.06% |
| ROGER WITHEROW & ASSOC3 Filed as: ROGER WITHEROW AND ASSOCIATES INC | 1517 HATCHER LANE COLUMBIA, TN 38401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $638 | $10K | 21.39% |
| W ROGER WITHEROW3 | P O BOX 375 COLUMBIA, TN 38402 | VISION SERVICE PLAN | $1K | — | $1K | 5.12% |
| ROGER WITHEROW & ASSOC3 Filed as: ROGER WITHEROW AND ASSOCIATES INC | 1517 HATCHER LANE COLUMBIA, TN 38401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $159 | $3K | 21.11% |
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 | 173 | 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. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 329 | $1.6M |
| Dental | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 329 | $1.6M |
| Vision | VISION SERVICE PLAN | 158 | $22K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $62K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 420 | $100K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 420 | $59K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 329 | $1.6M |
| Other(3 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 329 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.