| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 5100 POPLAR AVENUE, SUITE 1200 MEMPHIS, TN 38137 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $38K | $0 | $38K | 3.33% |
| USI INSURANCE SERVICES LLC3 | 5100 POPLAR AVENUE, SUITE 1200 MEMPHIS, TN 38137 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | $0 | $7K | 14.77% |
| BRIAN OBAL3 | 3190 FAIRVIEW PARK, SUITE 40 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $84 | $84 | 0.19% |
| SHAWN J KEELER3 Filed as: SHAWN J. KEELER | 211 SOUTH 23RD STREET PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 300 CHERAPA PLACE, SUITE 601 SIOUX FALLS, SD 57103 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
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 | 667 | 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) | 667 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 183 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 667 | $19K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 667 | $19K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 667 | $19K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 667 | $19K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 183 | $1.1M |
| Other(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 667 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 667 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.