| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM D STAEDKE3 | 25695 E 71ST S BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $3K | $7K | 11.70% |
| INTERNATIONAL INSURANCE BROKERS LTD3 | PO BOX 35487 TULSA, OK 74153 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 9.20% |
| SHANNON MARIE BALDWIN3 | 10222 E 114TH ST S BIXBY, OK 74008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $192 | $1K | 2.01% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $918 | $131 | $1K | 1.71% |
| MARILYNN DECKER3 | 5173 JOHN HAGAR RD HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $541 | $93 | $634 | 1.03% |
| BRENDA H BRIDGES3 | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $334 | $28 | $362 | 0.59% |
| JAMES A SHARP3 | 1021 TULIP BLOSSOM DRIVE HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $332 | $15 | $347 | 0.57% |
| BRANDI TAFT3 | 822 B NEARTOP DRIVE NASHVILLE, TN 37205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $249 | $29 | $278 | 0.45% |
| BENEFIT ENROLLMENT SERVICES INC3 Filed as: BENEFIT ENROLLMENT SERVICES, INC | 4300 SIDCO DR NASHVILLE, TN 37204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $176 | $56 | $232 | 0.38% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL RD SUITE 106 KNOXVILLE, TN 37919 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $9 | $161 | 0.26% |
| PAULA HARGIS3 | 101 WESLEY ROAD LENOIR CITY, TN 37772 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $95 | $8 | $103 | 0.17% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $27 | $65 | 0.11% |
| CARRIE ANN CAMPBELL3 | 5121 REDBUD DRIVE SAND SPRINGS, OK 74063 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.04% |
| JERRY W HOOPER3 | 6044 MAYSBROOK LANE FRANKLIN, TN 37064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.03% |
| MARLIN P DANIELSEN3 | 286 BORING CHAPEL RD GRAY, TN 37615 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.03% |
| DENNIS E TRAYWICK3 | 4300 SIDCO DRIVE NASHVILLE, TN 37204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| WILLIAM KYZER3 | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| JESSICA LEAH SCHNEIDER3 | 210 CARDEN AVE NASHVILLE, TN 37205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 0.01% |
| JUDY L CHANDLER3 | 8831 HEISKELL ROAD POWELL, TN 37849 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 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% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 147 | $61K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 147 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.