| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MATTHEW BOLES3 Filed as: MATTHEW C BOLES | 265 BROOKVIEW CENTRE WAY KNOXVILLE, TN 37919 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $197K | — | $197K | 2.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PLACE CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $71K | $15K | $86K | 18.20% |
| THE CASON GROUP INC3 Filed as: CASON GROUP, INC. | 1612 MARION ST FL 4 COLUMBUS, SC 29201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 1.82% |
| NICHOLAS MOOR WEISSFELD3 | 1309 KNIGHTSBRIDGE DR KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 12.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 1120 S TRYON ST STE 650 CHARLOTTE, NC 28203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 11.35% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LN HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $774 | $75 | $849 | 3.57% |
| BENEFOUNDRY INC3 | 3013 LARGE HOP LN ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $516 | $168 | $684 | 2.87% |
| NICHOLAS MOOR WEISSFELD3 | 1309 KNIGHTBRIDGE DR KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 25.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 1120 S TRYON ST STE 650 CHARLOTTE, NC 28203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 16.72% |
| BENEFOUNDRY INC3 | 3013 LARGE HOP LN ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $608 | $227 | $835 | 4.19% |
| NOCHOLAS MOOR WEISSFELD3 | 1309 KNIGHTSBRIDGE DR KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $850 | $3K | 14.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 1120 S TRYON ST STE 650 CHARLOTTE, NC 28203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 9.56% |
| BENEFOUNDRY INC3 | 3013 LARGE HOP LN ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $345 | $106 | $451 | 2.47% |
| SCOTT EUGENE BAKER3 | 118 KIMBERLY DR MORGANTON, NC 28655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS- SEE ATTACHMENT | POST OOFICE BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $430 | $3K | 16.40% |
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 | 815 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 817 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 963 | $7.3M |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 963 | $7.3M |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 963 | $7.3M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 882 | $474K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 882 | $474K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 882 | $474K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 882 | $552K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 963 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.