| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL INSURANCE BROKERS LTD3 | PO BOX 35487 TULSA, OK 74153 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $3K | — | $3K | 5.68% |
| WILLIAM D STAEDKE3 | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $2K | — | $2K | 4.35% |
| SHANNON MARIE BALDWIN3 | 14620 S 52ND EAST AVE BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1K | — | $1K | 2.35% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $527 | — | $527 | 1.17% |
| MARILYN K EMBERSON3 | 7220 N HAMMOND AVENUE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $329 | — | $329 | 0.73% |
| MARILYN DECKER3 | 5173 JOHN HAGAR RD HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $90 | — | $90 | 0.20% |
| BRANDI TAFT3 | 7325 AUTUMN CROSSING WAY BRENTWOOD, TN 37027 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $77 | — | $77 | 0.17% |
| BRENDA H BRIDGES3 | 223 SHADY LANE WHITE HOUSE, TN 37188 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $63 | — | $63 | 0.14% |
| ANGELA MASSARELLI3 Filed as: ANGELA J ZWEERS | 183 BRANDON WOODS DRIVE SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $51 | — | $51 | 0.11% |
| JAMES A SHARP3 | 1021 TULIP BLOSSOM DR HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $30 | — | $30 | 0.07% |
| JERRY W HOOPER3 | 6044 MAYSBROOK LANE FRANKLIN, TN 37064 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $8 | — | $8 | 0.02% |
| MARY DAUGHERTY3 | 7108 WEST CHERMONT CIRCLE KNOXVILLE, TN 37918 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $8 | — | $8 | 0.02% |
| DENNIS E TRAYWICK3 | 6738 FLAT CREEK RD COLLEGE GROVE, TN 37046 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $8 | — | $8 | 0.02% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL DR STE 201 KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $5 | — | $5 | 0.01% |
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 | 85 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 85 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE CO. | 85 | $45K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE CO. | 85 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 85 | — |
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.
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.