| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ORMA R SMITH III3 Filed as: ORMA R SMITH | 3725 CHAMPION HILLS DRIVE STE 3300 MEMPHIS, TN 38125 | BLUECROSS BLUESHIELD OF TENNESSEE INC | $39K | $0 | $39K | 3.77% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC DBA CAN | 3725 CHAMPION HILLS DRIVE STE 3300 MEMPHIS, TN 38125 | DELTA DENTAL OF TENNESSEE | $6K | $0 | $6K | 10.00% |
| SMITH III, ORMA R3 | 3725 CHAMPION HILLS DR STE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $264 | $2K | 10.66% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC | 3725 CHAMPION HILLS DRIVE STE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $413 | $31 | $444 | 2.57% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC | 3725 CHAMPION HILLS DRIVE STE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $117 | $2K | 15.75% |
| STREAMLINE ENTERPRISES LLC Filed as: STREAMLINE ENTERPRISES, LLC | 3725 CHAMPION HILLS DRIVE STE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $220 | $110 | $330 | 2.25% |
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 | 129 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE INC | 129 | $1.0M |
| Dental | DELTA DENTAL OF TENNESSEE | 152 | $57K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE INC | 129 | $1.0M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 147 | $17K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 50 | $16K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 147 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.