| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL INSURANCE BROKERS LTD3 | PO BOX 35487 TULSA, OK 74153 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 6.54% |
| WILLIAM D STAEDKE3 | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 6.04% |
| SHANNON MARIE BALDWIN3 | 14620 S 52ND EAST AVE BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.15% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $532 | $0 | $532 | 1.52% |
| MARILYN K EMBERSON3 | 7220 N HAMMOND AVE WARR ACRES, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $293 | $0 | $293 | 0.84% |
| MARILYNN DECKER3 | 5173 JOHN HAGAR RD HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $0 | $80 | 0.23% |
| BRANDI TAFT3 | 6413 PREMIER DR NASHVILLE, TN 37209 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | $0 | $66 | 0.19% |
| BRENDA H BRIDGES3 | 223 SHADY LN WHITE HOUSE, TN 37188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $0 | $58 | 0.17% |
| ANGELA MASSARELLI3 Filed as: ANGELA J ZWEERS | 183 BRANDON WOODS DR SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.07% |
| JAMES A SHARP3 | 1021 TULIP BLOSSOM DR HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.05% |
| JERRY W HOOPER3 | 5809 LEGGETT LN THE VILLAGES, FL 32163 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.02% |
| DENNIS E TRAYWICK3 | 6738 FLAT CREEK RD COLLEGE GROVE, TN 37046 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.02% |
| MARY DAUGHERTY3 | PO BOX 119 ROCKY TOP, TN 37769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 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 | 76 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 76 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 76 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 76 | — |
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.