| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEBORAH FARMER SAMPLES3 Filed as: DEBORAH SAMPLES | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | BLUERE OF TENNESSEE | $45K | — | $45K | 9.12% |
| CARLA STINER REEL3 | 6500 PAPERMILL RD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42K | $7K | $50K | 11.42% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15K | $3K | $18K | 4.17% |
| DEBORAH FARMER SAMPLES3 | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | — | $14K | 3.11% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $3K | $12K | 2.77% |
| DEIRDRE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $273 | $2K | 0.44% |
| MARARET M GRAHAM3 | 200 CROOKED CREEK DR ONEIDA, TN 37841 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $154 | $2K | 0.39% |
| VICTORIA PAULIN3 | 172 SUNRISE DR ELIZABETHTON, TN 37830 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.38% |
| PENELOPE DEAN KENNY3 | 3555 S OCEAN BLVD APT 215 S PALM BEACH, FL 33480 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $43 | $1K | 0.33% |
| WILLIAM KYZER3 | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $869 | $165 | $1K | 0.24% |
| EDGHILL ENTERPRISES LLC3 | 3403 E SEEBLING MILE RD GRAND ISLAND, NE 68801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $205 | $29 | $234 | 0.05% |
| PAULA HARGIS3 | 101 WESLEY RD LENOIR CITY, TN 37772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $216 | $11 | $227 | 0.05% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE MARIE STUEMKY | 10208 MIDDLE DARLEEN LEANDER, TX 78641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $190 | $7 | $197 | 0.05% |
| DONNA ROSS SMITH3 | 2632 JUDES FERRY RD POWHATAN, VA 23139 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $141 | $23 | $164 | 0.04% |
| KIMBERLY FERGUSON3 | 4059 LOMAR DRIVE MT AIRY, MD 21771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $96 | $39 | $135 | 0.03% |
| ROSEANN REYNOLDS3 | 163 CEDAR ST BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $74 | $129 | 0.03% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $42 | $117 | 0.03% |
| DAVID L FLEURY3 | 545 SOUTH WATER ST PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $51 | $95 | 0.02% |
| REBECCA C KYZER3 Filed as: REBECCA COLEMAN KYZER | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.02% |
| VENESSA N DEAN3 | 92 LIMEWOOD AVE BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $1 | $57 | 0.01% |
| KEVIN MURPHY3 Filed as: KEVIN ARMSTRONG INSURANCE INC | 4027 WEST FAIDLEY GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $21 | $42 | 0.01% |
| OPTIO LLC3 | 8547 E ARAPAHOE RD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $1 | $17 | 0.00% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.00% |
| ROBERT E PAGANI3 | 10840 SUNSET HILLS DRIVE RICHMOND, VA 23236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.00% |
| 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 | 6500 PAPERMILL RD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $711 | $6K | 8.68% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $258 | $2K | 2.91% |
| DEBORAH FARMER SAMPLES3 | 699 INDIAN RIVER BOAT DOCK RD JACKSBORO, TN 37757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.73% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $412 | $2K | 2.45% |
| MARGARET M GRAHAM3 | 200 CROOKED CREEK DR ONEIDA, TN 37841 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $738 | $70 | $808 | 1.23% |
| VICTORIA PAULIN3 | 172 SUNRISE DR ELIZABETHTON, TN 37643 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $321 | — | $321 | 0.49% |
| PENELOPE DEAN KENNY3 | 3555 S OCEAN BLVD APT 215 S PALM BEACH, FL 33480 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $175 | $5 | $180 | 0.27% |
| PAULA HARGIS3 | 101 WESLEY RD LENOIR CITY, TN 37772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | $6 | $125 | 0.19% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE MARIE STUEMKY | 10208 MIDDLE DARLEEN LEANDER, TX 78641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $1 | $45 | 0.07% |
| DIERDRE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $7 | $41 | 0.06% |
| WILLIAM KYZER3 | P.O. BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $5 | $33 | 0.05% |
| ROSEANN REYNOLDS3 | 163 CEDAR ST BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $10 | $18 | 0.03% |
| DAVID L FLEURY3 | 545 SOUTH MAIN ST PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $7 | $13 | 0.02% |
| VENESSA N DEAN3 | 92 LIMEWOOD AVE BRANFORD, CT 06405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.01% |
| OPTIO LLC3 | 8547 E ARAPAHOE RD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.01% |
| LERMAN VENTURES INC3 | 2985 SURREY RIDGE ROAD CLARKSVILLE, TN 37043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.01% |
| CARLA STINER REEL3 Filed as: CARLA S REEL | 6500 PAPERMILL RD STE 106 KNOXVILLE, TN 37919 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.50% |
| 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 | 4.50% |
| CARLA STINER REEL3 | 6500 PAPERMILL RD KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $128 | $2K | 6.66% |
| DEBORAH FARMER SAMPLES3 | 699 INDIAN RIVER BOAT DOCK RD. JACKSBORO, TN 37757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $712 | — | $712 | 2.81% |
| MARY DAUGHERTY3 | 4639 WELLINGTON POINT LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | $13 | $160 | 0.63% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $3 | $9 | 0.04% |
| 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 | 13.85% |
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 | 385 | 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) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 403 | $526K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 292 | $500K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 224 | $47K |
| Stop-loss / reinsurancereinsurance | BLUERE OF TENNESSEE | 567 | $491K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 292 | $514K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 567 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.