| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AUSTIN MADISON3 | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | $56K | $0 | $56K | 1.07% |
| PAGE VOGELSANG3 Filed as: PAGE VOLGELSANG | 3657 BRIARPARK DR., SUITE 700 HOUSTON, TX 77042 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | $11K | $0 | $11K | 0.21% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | $9K | $0 | $9K | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $70K | $0 | $70K | 9.57% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $19K | $0 | $19K | 2.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 3635 RIVERSIDE PLAZA DR. SUITE 300 RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 0.83% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 0.45% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, STE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.20% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $217 | $217 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | DELTAL DENTAL OF TENNESSEE | $5K | $0 | $5K | 1.35% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | DELTAL DENTAL OF TENNESSEE | $2K | $0 | $2K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.71% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $871 | $0 | $871 | 1.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $974 | $0 | $974 | 10.19% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | METROPOLITAN GENERAL INSURANCE COMPANY | $330 | $0 | $330 | 11.55% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES - KANSAS CITY SER | PO BOX 843844 KANSAS CITY, MO 64184 | METROPOLITAN GENERAL INSURANCE COMPANY | -$315 | $0 | -$315 | -11.03% |
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 | 1,105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | 808 | $5.2M |
| Dental | DELTAL DENTAL OF TENNESSEE | 848 | $399K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 464 | $54K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,405 | $732K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,405 | $732K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,405 | $732K |
| Other(5 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,405 | $793K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,405 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.