| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$5K | $7K | $1K | 0.13% |
| BRIAN P GALLANT3 | 38 CHAMBERLAIN AVE PORTLAND, ME 04101 | AFLAC | $4K | $300 | $4K | 2.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CHRISTOPHER C D BROWN | 370 SILVER PLUM COVE NUMBER 8 COLLIERVILLE, TN 38017 | AFLAC | $4K | $157 | $4K | 2.81% |
| ELAINE C HANSON3 | 30 CUSHNOC ROAD VASSALBORO, ME 04989 | AFLAC | $3K | $140 | $3K | 2.01% |
| DAVID G WILLIAMS3 | 108 COUNTRYSIDE DR HENDERSONVILLE, TN 37077 | AFLAC | $2K | — | $2K | 1.26% |
| JENNIFER C BOREK3 | 3095 E PATRICK LN STE 1 LAS VEGAS, NV 89120 | AFLAC | $1K | — | $1K | 0.89% |
| KENNETH R APPLE3 | 830 WILLOW TREE CIRCLE CORDOVA, TN 38018 | AFLAC | $890 | — | $890 | 0.60% |
| JAKE ENTERPRISES INC3 | 25 LOCKLAND DRIVE PO BOX 1977 WINDHAM, ME 04062 | AFLAC | $662 | — | $662 | 0.44% |
| JUSTIN S PIYAVUNNO3 | 1014 PHEASANT HOLLOW DR CORDOVA, TN 38018 | AFLAC | $470 | — | $470 | 0.32% |
| MELISSA NELSON3 | 28 ARIEL STREET LINCOLN, ME 04457 | AFLAC | $420 | — | $420 | 0.28% |
| ROBERT R KURTZ3 | 306 BEECH HILL RD AUBURN, ME 39278 | AFLAC | $393 | — | $393 | 0.26% |
| SCOTT A. MCCOY3 | 108 STATE STREET STE 1 BANGOR, ME 04401 | AFLAC | $283 | $73 | $356 | 0.24% |
| JAMES (JAY) GRIMES3 | 4272 PERSIMMON WOODS DR NORTH CHARLESTON, SC 29420 | AFLAC | $326 | — | $326 | 0.22% |
| SCOTT HUNTLEY3 | 108 STATE ST. STE 1 BANGOR, ME 04401 | AFLAC | $284 | — | $284 | 0.19% |
| WILLIAM T HENRY3 | ONE SUNDIAL AVE SUITE 212N MANCHESTER, NH 03103 | AFLAC | $127 | $73 | $200 | 0.13% |
| GREG GRIFFITH3 Filed as: GREG W GRIFFITH | 393 TENNESSEE STREET APT 1 MEMPHIS, TN 38103 | AFLAC | $151 | — | $151 | 0.10% |
| ROBERT GOBLE3 | 1410 4TH STREET DRIVE NW UNIT 208 HICKORY, NC 28601 | AFLAC | $119 | — | $119 | 0.08% |
| LEO E SOUCY3 | 402 BALCOM RD NEWPORT, WA 99156 | AFLAC | $45 | — | $45 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: RONALD F BROWN | 5150 BAY TOWN CONWAY, AR 72034 | AFLAC | $32 | — | $32 | 0.02% |
| ARTHUR M JONES JR3 | PO BOX 1518 BANGOR, ME 04402 | AFLAC | $14 | — | $14 | 0.01% |
| ALAN L FLOOD3 | 7 FLOOD ROAD PLYMOUTH, ME 04969 | AFLAC | $5 | — | $5 | 0.00% |
| BARBARA TORRES3 | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $3 | — | $3 | 0.00% |
| MAYNARD M. YOUNG3 Filed as: MAYNARD YOUNG | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $1 | — | $1 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $488 | $488 | 0.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CHRISTOPHER C D BROWN | 370 SILVER PLUM COVE NUMBER 8 COLLIERVILLE, TN 38017 | AFLAC | $1K | — | $1K | 4.12% |
| DAVID G WILLIAMS3 | 108 COUNTRYSIDE DRIVE HENDERSONVILLE, TN 37075 | AFLAC | $642 | — | $642 | 2.26% |
| KENNETH R APPLE3 Filed as: KENNETH R. APPLE | 830 WILLOW TREE CIRCLE CORDOVA, TN 38018 | AFLAC | $344 | — | $344 | 1.21% |
| BRITT CURNOW3 Filed as: BRITT E CURNOW | 817 US HIGHWAY 2 S CRYSTAL FALLS, MI 49920 | AFLAC | $263 | — | $263 | 0.93% |
| JENNIFER C BOREK3 Filed as: JENNIFER C. BOREK | 3095 E PATRICK LN STE 1 LAS VEGAS, NV 89120 | AFLAC | $242 | — | $242 | 0.85% |
| ELAINE C HANSON3 | 30 CUSHNOC ROAD VASSALBORO, ME 04989 | AFLAC | $197 | — | $197 | 0.69% |
| JUSTIN S PIYAVUNNO3 | 1014 PHEASANT HOLLOW DRIVE CORDOVA, TN 38018 | AFLAC | $84 | — | $84 | 0.30% |
| JAKE ENTERPRISES INC3 | 25 LOCKLAND DRIVE PO BOX 1977 WINDHAM, ME 04062 | AFLAC | $76 | — | $76 | 0.27% |
| BRIAN P GALLANT3 | 38 CHAMBERLAIN AVE PORTLAND, ME 04101 | AFLAC | $64 | — | $64 | 0.23% |
| JENNIFER L LOFHOLM3 | W6078 PIERS GORGE RD NORWAY, MI 49870 | AFLAC | $51 | — | $51 | 0.18% |
| SHARON M WATSON3 | 4273 CHERRY CENTER DR SUITE 10 MEMPHIS, TN 38118 | AFLAC | $45 | — | $45 | 0.16% |
| JAMES D STEPHENS3 Filed as: JAMES D. STEPHENS | 26710 MANDRAKE FALLS CT KATY, TX 77949 | AFLAC | $40 | — | $40 | 0.14% |
| ROBERT L GOBLE3 | 6008 NC HWY 16S TAYLORSVILLE, NC 28681 | AFLAC | $35 | — | $35 | 0.12% |
| DEREK RAY BLAIS3 | 4959 N FOSTER ST FOUNTAIN, MI 49410 | AFLAC | $30 | — | $30 | 0.11% |
| GREG GRIFFITH3 Filed as: GREG W GRIFFITH | 393 TENNESSEE ST APT 1 MEMPHIS, MS 38103 | AFLAC | $29 | — | $29 | 0.10% |
| JAMES (JAY) GRIMES3 | 4272 PERSIMMON WOODS DR NORTH CHARLESTON, SC 29420 | AFLAC | $26 | — | $26 | 0.09% |
| PATRICIA GROGAN3 Filed as: PATRICIA A GROGAN | 430 RIVER POINTE PARKWAY UNIT 101 KINGSFORD, MI 49802 | AFLAC | $19 | — | $19 | 0.07% |
| JASON BRINKMEYER3 | 170 TURTLE CREEK DR JACKSON, TN 38305 | AFLAC | $19 | — | $19 | 0.07% |
| MARY E SCHATZ3 | 1101 TONTI ROAD MARQUETTE, MI 49855 | AFLAC | $17 | — | $17 | 0.06% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: RONALD F BROWN | 5150 BAY TOWN CONWAY, AR 72034 | AFLAC | $12 | — | $12 | 0.04% |
| HOWARD EATON3 | 1377 CARMONY ST COLLIERVILLE, TN 38017 | AFLAC | $8 | — | $8 | 0.03% |
| MELISSA NELSON3 | 28 ARIEL STREET LINCOLN, ME 04457 | AFLAC | $7 | — | $7 | 0.02% |
| SCOTT A. MCCOY3 Filed as: SCOTT A MCCOY | 108 STATE ST SUITE 1 BANGOR, ME 04401 | AFLAC | $7 | — | $7 | 0.02% |
| JENNIFER C JENNINGS3 | 238 RAE DRIVE MUNFORD, TN 38058 | AFLAC | $6 | — | $6 | 0.02% |
| DOUGLAS E FOX3 Filed as: DOUGLAS EDWARD FOX | 735 S GARFIELD AVE STE 203 TRAVERSE CITY, MI 49686 | AFLAC | $5 | — | $5 | 0.02% |
| ROBERT R KURTZ3 | 306 BEECH HILL RD AUBURN, ME 04210 | AFLAC | $4 | — | $4 | 0.01% |
| JOSHUA LEE JONES3 | 18032 DEERCLIFF CT GLENCOE, MO 63038 | AFLAC | $2 | — | $2 | 0.01% |
| BRITT CURNOW3 Filed as: BRITT E CURNOW | 817 US HIGHWAY 2 S CRYSTAL FALLS, MI 49920 | AFLAC | $988 | $16 | $1K | 4.10% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CHRISTOPHER C D BROWN | 370 SILVER PLUM COVE NUMBER 8 COLLIERVILLE, TN 38017 | AFLAC | $730 | $7 | $737 | 3.01% |
| JENNIFER L LOFHOLM3 | W6078 PIERS GORGE RD NORWAY, MI 49870 | AFLAC | $406 | — | $406 | 1.66% |
| KENNETH R APPLE3 | 830 WILLOW TREE CIRCLE CORDOVA, TN 38018 | AFLAC | $174 | — | $174 | 0.71% |
| DEREK RAY BLAIS3 | 4959 N FOSTER ST FOUNTAIN, MI 49410 | AFLAC | $172 | — | $172 | 0.70% |
| MARY E SCHATZ3 | 1102 TONTI ROAD MARQUETTE, MI 49855 | AFLAC | $166 | $3 | $169 | 0.69% |
| DAVID G WILLIAMS3 | 108 COUNTRYSIDE DR HENDERSONVILLE, TN 37075 | AFLAC | $95 | — | $95 | 0.39% |
| DOUGLAS E FOX3 Filed as: DOUGLAS EDWARD FOX | 735 S GARFIELD AVE STE 203 TRAVERSE CITY, MI 49686 | AFLAC | $40 | $3 | $43 | 0.18% |
| SANDRA FARBER BOSK3 Filed as: SANDRA FARBER-BOSK | 918 N LINCOLN RD ESCANABA, MI 49829 | AFLAC | $37 | $3 | $40 | 0.16% |
| ROBERT L GOBLE3 | 1410 4TH STREET DR NW UNIT 208 HICKORY, NC 28601 | AFLAC | $16 | — | $16 | 0.07% |
| JAMES D STEPHENS3 Filed as: JAMES D. STEPHENS | 26710 MANDRAKE FALLS CT KATY, TX 77494 | AFLAC | $15 | — | $15 | 0.06% |
| HOWARD EATON3 | 1377 CARMONY ST CLIIERVILLE, TN 38017 | AFLAC | $7 | — | $7 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: RONALD F BROWN | 5150 BAY TOWN ROAD CONWAY, AR 72034 | AFLAC | $7 | — | $7 | 0.03% |
| PATRICIA GROGAN3 | 430 RIVER POINTE PARKWAY UNIT 101 KINGSFORD, MI 49802 | AFLAC | $2 | — | $2 | 0.01% |
| VBTN, INC3 Filed as: VBTN, INC. | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | -$1 | $1 | $0 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CHRISTOPHER C D BROWN | 370 SILVER PLUM COVE NUMBER 8 COLLIERVILLE, TN 38017 | AFLAC | $503 | $11 | $514 | 4.18% |
| BRITT CURNOW3 Filed as: BRITT E CURNOW | 817 US HIGHWAY 2 S CRYSTAL FALLS, MI 49920 | AFLAC | $370 | $25 | $395 | 3.21% |
| DAVID G WILLIAMS3 | 108 COUNTRYSIDE DR HENDERSONVILLE, TN 37075 | AFLAC | $115 | — | $115 | 0.94% |
| JENNIFER L LOFHOLM3 | W6078 PIERS GORGE RD NORWAY, MI 49870 | AFLAC | $109 | — | $109 | 0.89% |
| KENNETH R APPLE3 | 830 WILLOW TREE CIRCLE CORDOVA, TN 38018 | AFLAC | $84 | — | $84 | 0.68% |
| SHARON M WATSON3 | 4273 CHERRY CENTER DR SUITE 10 MEMPHIS, TN 38118 | AFLAC | $83 | — | $83 | 0.68% |
| MICHAEL D AISSEN3 | 920 HOLCOMB BRIDGE RD STE 200 ROSWELL, GA 30076 | AFLAC | $70 | — | $70 | 0.57% |
| DEREK RAY BLAIS3 | 4959 N FOSTER ST FOUNTAIN, MI 49410 | AFLAC | $64 | — | $64 | 0.52% |
| PATRICIA GROGAN3 Filed as: PATRICIA A GROGAN | 430 RIVER POINTE PARKWAY UNIT 101 KINGSFORD, MI 49802 | AFLAC | $23 | $5 | $28 | 0.23% |
| DOUGLAS E FOX3 Filed as: DOUGLAS EDWARD FOX | 735 S GARFIELD AVE STE 203 TRAVERSE CITY, MI 49686 | AFLAC | $21 | $5 | $26 | 0.21% |
| JAMES D STEPHENS3 | 26710 MANDRAKE FALLS CT KATY, TX 77494 | AFLAC | $25 | — | $25 | 0.20% |
| MARY E SCHATZ3 | 1102 TONTI ROAD MARQUETTE, MI 49855 | AFLAC | $16 | $5 | $21 | 0.17% |
| ROBERT L GOBLE3 | 1410 4TH STREET DR NW UNIT 208 HICKORY, NC 28601 | AFLAC | $10 | — | $10 | 0.08% |
| ARTHUR M PRIDDY3 | 214 LIBERTY RD JACKSON, TN 38305 | AFLAC | $8 | — | $8 | 0.07% |
| JEFFREY W XAVER3 | 3982 ARLINGTON DR WILLIAMSBURG, MI 49690 | AFLAC | $6 | — | $6 | 0.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: RONALD F BROWN | 5150 BAY TOWN CONWAY, AR 72034 | AFLAC | $6 | — | $6 | 0.05% |
| VBTN, INC3 Filed as: VBTN, INC. | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $3 | $2 | $5 | 0.04% |
| JASON BRINKMEYER3 | 170 TURTLE CREEK DR JACKSON, TN 38305 | AFLAC | $3 | — | $3 | 0.02% |
| BRIAN J DAY3 | 8744 UNION CENTRE BLVD SUITE 500 WEST CHESTER, OH 45069 | AFLAC | $2 | — | $2 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $48 | $1K | 20.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 CAMERON HILL CIRCLE CHATTANOOGA, TN 37402 | $916K |
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 | 1,367 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 94 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,367 | $997K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 515 | $73K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 806 | $511K |
| Other(6 contracts, 2 carriers) | AFLAC | 1,367 | $283K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,367 | — |
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.