| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM D STAEDKE3 | 25695 E 7ST S BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $6K | 10.96% |
| INTERNATIONAL INSURANCE BROKERS LTD3 | PO BOX 35487 TULSA, OK 74153 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 9.12% |
| MARILYNN DECKER3 | 5173 JOHN HAGAR RD HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $964 | $176 | $1K | 2.27% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $661 | — | $661 | 1.32% |
| BENEFIT ENROLLMENT SERVICES INC3 Filed as: BENEFIT ENROLLMENT SERVICES | 4300 SIDCO DR NASHVILLE, TN 37204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $231 | $412 | $643 | 1.28% |
| MARILYN K EMBERSON3 | 7220 N HAMMOND AVENUE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $557 | — | $557 | 1.11% |
| JAMES A SHARP3 | 1021 TULIP BLOSSOM DRIVE HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $398 | $57 | $455 | 0.91% |
| CARRIE ANN CAMPBELL3 | 5121 REDBUD DRIVE SAND SPRINGS, OK 74063 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $304 | — | $304 | 0.61% |
| BRANDI TAFT3 | 822 B NEARTOP DRIVE NASHVILLE, TN 37205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $202 | $31 | $233 | 0.46% |
| SHANNON MARIE BALDWIN3 | 10222 E 114TH ST S BIXBY, OK 74008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $205 | $3 | $208 | 0.41% |
| MARLIN P DANIELSEN3 | 286 BORING CHAPEL RD GRAY, TN 37615 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $201 | — | $201 | 0.40% |
| BRENDA H BRIDGES3 | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $47 | $173 | 0.34% |
| LERMAN VENTURES INC3 Filed as: LERMAN VENTURES, INC | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $7 | $40 | 0.08% |
| JERRY W HOOPER3 | 741 BRESSLYN RD NASHVILLE, TN 37205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.05% |
| DENNIS E TRAYWICK3 | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.03% |
| WILLIAM KYZER3 | 8211 GORDON LN HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $2 | $13 | 0.03% |
| JESSICA LEAH SCHNEIDER3 | 210 CARDEN AVE NASHVILLE, TN 37205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| JUDY L CHANDLER3 | 8831 HEISKELL ROAD POWELL, TN 37849 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| REBECCA C KYZER3 Filed as: REBECCA COLEMAN KYZER | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| TONYA BELL3 | 3228 CLAPHAM ROAD ANTIOCH, TN 37013 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH N MEACHAM | PO BOX 363 ANDERSONVILLE, TN 37705 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| DEBORAH C BUSH3 | 2962 BABY RUTH LANE ANTIOCH, TN 37013 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 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 | 119 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 119 | $50K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 119 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.