| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT VINCENT3 | 22 CENTURY BLVD STE 150 NASHVILLE, TN 37214 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $28K | — | $28K | 4.55% |
| CHARLES S MADISON3 Filed as: CHARLES E BOYD | 612 CROFTON PARK LN FRANKLIN, TN 37069 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $13K | — | $13K | 2.02% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $3K | $14K | 7.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2487 CEDARCREST ROAD, STE 222 ACWORTH, GA 30101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.86% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 165 | $619K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $187K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $187K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $187K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $187K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $187K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.