| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM D STAEDKE3 | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 6.15% |
| INTERNATIONAL INSURANCE BROKERS LTD3 | PO BOX 35487 TULSA, OK 74153 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $995 | — | $995 | 2.08% |
| SHANNON MARIE BALDWIN3 | 10222 E 114TH ST S BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $817 | — | $817 | 1.71% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $629 | — | $629 | 1.32% |
| MARILYN K EMBERSON3 | 7220 N HAMMOND AVENUE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $457 | — | $457 | 0.96% |
| MARILYNN DECKER3 | 5173 JOHN HAGAR RD HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $411 | — | $411 | 0.86% |
| BRENDA H BRIDGES3 | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $218 | — | $218 | 0.46% |
| BENEFIT ENROLLMENT SERVICES INC3 | 4701 TROUSDALE DRIVE NASHVILLE, TN 37220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 0.22% |
| JAMES A SHARP3 | 1021 TULIP BLOSSOM DRIVE HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.07% |
| MARY DAUGHERTY3 | 7625 STAR GAZING LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.03% |
| JERRY W HOOPER3 | 6044 MAYSBROOK LANE FRANKLIN, TN 37064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| LALETTA SMITH3 | 118 ROSE GARDEN LANE GOODLETTSVILLE, TN 37072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 175 | $48K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 175 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.