| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM RUSSELL BLAKELY & ASSOC3 Filed as: WILLIAM WATSON | 735 BROAD STREET STE 100 CHATTANOOGA, TN 37402 | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | $86K | — | $86K | 3.69% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS CAPITAL, INC. | PO BOX 1388 VENTURA, CA 930021388 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 6.87% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32100 AGOURA ROAD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 2.38% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $5K | $20K | 20.03% |
| THE BENEFIT COMPANY INC5 Filed as: THE BENEFIT COMPANY INC. | P.O. BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.88% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $4K | $15K | 19.92% |
| THE BENEFIT COMPANY INC5 Filed as: THE BENEFIT COMPANY INC. | P.O. BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.53% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 414 GALLIMORE DAIRY RD GREENSBORO, NC 27409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 10.97% |
| THE BENEFIT COMPANY INC5 | PO BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 9.45% |
| TOLMAN AND WIKER INS. SVCS., LLC3 Filed as: TOLMAN & WIKER INSURANCE SERVICES | 196 SOUTH FIR STREET VENTURA, CA 93002 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $982 | — | $982 | 9.09% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INSURANCE SER | 1425 RIVER PARK DRIVE SUITE 226 SACRAMENTO, CA 93002 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $187 | — | $187 | 1.73% |
| THE BENEFIT COMPANY INC5 | PO BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 24.31% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $407 | $2K | 20.17% |
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 | 272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | 280 | $2.5M |
| Dental(2 contracts, 2 carriers) | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | 280 | $2.3M |
| Vision(2 contracts, 2 carriers) | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | 280 | $2.3M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $109K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $71K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $75K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.