| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 26 CENTURY BLVD NASHVILLE, TN 37214 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $6K | $35K | 2.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 1445 ROSS AVE SUITE 4200 DALLAS, TX 752022820 | METROPOLITAN LIFE INSURANCE COMPANY | $33K | $1K | $34K | 2.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 26 CENTURY BLVD NASHVILLE, TN 37214 | KANSAS CITY LIFE INSURANCE COMPANY | $59K | — | $59K | 20.02% |
| MARK J POMARO & ASSOCIATES3 | 5313 SANDY TRAIL COURT PLANO, TX 75023 | NORTH AMERICAN SPECIALTY INS | $10K | — | $10K | 17.50% |
| COMBINED INDEPENDENT AGENCIES3 | 14785 PRESTON RD SUITE 350 DALLAS, TX 75254 | NORTH AMERICAN SPECIALTY INS | $2K | $3K | $5K | 8.48% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ANCHOR RISK MANAGEMENT | 14785 PRESTON RD SUITE 350 DALLAS, TX 75254 | NORTH AMERICAN SPECIALTY INS | — | $2K | $2K | 3.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 1445 ROSS AVENUE SUITE 4200 DALLAS, TX 75202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $444 | $2K | $2K | 6.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 701 MARKET ST SUITE 500 CHATTANOOGA, TN 37402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $871 | — | $871 | 2.32% |
| THE MATHIS-HILL-ROBERTSON AGENCY3 Filed as: THE MATHIS-HILL-ROBERTSON AGEN | 5040 ROSWELL RD SUITE 100 ATLANTA, GA 30342 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSE, INC. | SUMMIT GLOBAL EMERSON REID LLC KNOXVILLE, TN 37919 | GERBER LIFE INSURANCE CO. | $505 | — | $505 | 10.34% |
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 | 2,495 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 48 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,543 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 5,813 | $1.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,813 | $1.6M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,309 | $186K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 5,813 | $1.6M |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,813 | $1.9M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 5,813 | $1.6M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 281 | $1.3M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 5,813 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,813 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.