| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT SWEALT III | LOCKTON CO LLC 444 W 47TH ST KANSAS CITY, MO 64112 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $86K | — | $86K | 3.68% |
| DEBORAH FARMER SAMPLES3 Filed as: DEBORAH SAMPLES | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | BLUECROSS BLUESHIELD OF TENNESSEE, INC | $10K | — | $10K | 0.43% |
| CARLA STINER REEL3 | 6500 PAPERMILL ROAD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29K | $15K | $43K | 17.51% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DRIVE KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $7K | $14K | 5.67% |
| DEBORAH FARMER SAMPLES3 | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 4.57% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 4.06% |
| VICTORIA PAULIN3 | 505 N ROANE ST HARRIMAN, TN 37748 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $235 | $6K | 2.62% |
| DEIDRA B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $799 | $6K | 2.39% |
| MARGARET M GRAHAM3 | 200 CROOKED CREEK DR ONEIDA, TN 37841 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $465 | $5K | 1.98% |
| PENELOPE DEAN KENNY3 | 3555 S OCEAN BLVD APT 215 S PALM BEACH, FL 33480 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $761 | $5K | 1.98% |
| WILLIAM KYZER3 | P.O. BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $417 | $3K | 1.18% |
| EDGEHILL ENTERPRISES LLC3 | 2116 W KOEING GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $930 | $241 | $1K | 0.47% |
| JAZQUELINE MARIE STUEMKY3 | 10208 MIDDLE DARLEEN LEANDER, TX 78641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $742 | $156 | $898 | 0.36% |
| DONNA ROSS SMITH3 | 2632 JUDES FERRY RD POWHATAN, VA 23139 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $526 | $166 | $692 | 0.28% |
| KIMBERLY FERGUSON3 | 4059 LOMAR DRIVE MT AIRY, MD 21771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $370 | $237 | $607 | 0.25% |
| ROSEANN REYNOLDS3 | 163 CEDAR ST BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $207 | $187 | $394 | 0.16% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $255 | $103 | $358 | 0.14% |
| DAVID L FLEURY3 | 545 SOUTH MAIN ST PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $161 | $190 | $351 | 0.14% |
| REBECCA C KYZER3 Filed as: REBECCA COLEMAN KYZER | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $262 | — | $262 | 0.11% |
| VENESSA N DEAN3 | 92 LIMEWOOD AVE BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $207 | $15 | $222 | 0.09% |
| KEVIN MURPHY3 Filed as: KEVIN ARMSTRONG INSURANCE INC | 4027 WEST FAIDLEY GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $80 | $172 | 0.07% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $23 | $123 | 0.05% |
| OPTIO LLC3 | 8547 E ARAPAHOE RD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | $37 | $123 | 0.05% |
| ROBERT E PAGANI3 | 10840 SUNSET HILLS DRIVE RICHMOND, VA 23236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $2 | $23 | 0.01% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $5 | $18 | 0.01% |
| CARLA STINER REEL3 | 6500 PAPERMILL RD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $3K | $9K | 17.07% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $971 | $3K | 5.56% |
| JOSEPH M TAMER3 | 6500 PAPERMILL RD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 5.35% |
| DEBORAH FARMER SAMPLES3 | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.13% |
| MARGARET M GRAHAM3 | 200 CROOKED CREEK DR ONEIDA, TN 37841 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $207 | $2K | 3.92% |
| VICTORIA PAULIN3 | 505 N ROANE ST HARRIMAN, TN 37748 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $47 | $1K | 2.32% |
| PENELOPE DEAN KENNY3 | 3555 S OCEAN BLVD APT 215 S PALM BEACH, FL 33480 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $440 | $81 | $521 | 0.94% |
| DEIRDRE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | $16 | $117 | 0.21% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE MARIE STUEMKY | PO BOX 5014 BUFFALO CREEK, CO 80425 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $19 | $111 | 0.20% |
| ROSEANN REYNOLDS3 | 163 CEDAR ST BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $23 | $49 | 0.09% |
| DAVID L FLEURY3 Filed as: DAVID L. FLEURY | 545 SOUTH MAIN ST PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $23 | $42 | 0.08% |
| VENESSA N DEAN3 | 92 LIMEWOOD AVE BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $2 | $28 | 0.05% |
| OPTIO LLC3 | 8547 E ARAPAHOE RD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $6 | $20 | 0.04% |
| WILLIAM KYZER3 | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $2 | $14 | 0.03% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $2 | $11 | 0.02% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| CARLA STINER REEL3 Filed as: CARLA S REEL | 6500 PAPERMILL RD STE 106 KNOXVILLE, TN 37919 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 11.06% |
| DEBORAH FARMER SAMPLES3 Filed as: DEBORAH F SAMPLES | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.74% |
| CARLA STINER REEL3 | 6500 PAPERMILL RD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $685 | $2K | 9.33% |
| DEBORAH FARMER SAMPLES3 | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $615 | — | $615 | 2.82% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | $53 | $169 | 0.78% |
| THOMAS JENKINS PARKER3 Filed as: THOMAS WILSON GROUP LLC | 5214 MARYLAND WAY STE 303 BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
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 | 531 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 531 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC | 531 | $2.3M |
| Life insurance(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 390 | $325K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 296 | $303K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 200 | $38K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 296 | $316K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 531 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.