| 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. | $30K | — | $30K | 1.57% |
| ROBERT HUFFAKER JR3 | 736 MARKET ST STE 1000 CHATTANOOGA, TN 37402 | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | $25K | — | $25K | 1.28% |
| STEPHEN HUNGATE3 | 736 MARKET ST STE 1000 CHATTANOOGA, TN 37402 | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | $17K | — | $17K | 0.87% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS CAPITAL, INC. | PO BOX 1388 VENTURA, CA 930021388 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 6.92% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 2.38% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 125 N CENTRAL AVE FL 2 STAUNTON, VA 24401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | — | $14K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 200 PINE ST W FL 1 WILSON, NC 27893 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.74% |
| THE BENEFIT COMPANY INC5 | PO BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.04% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 125 N CENTRAL AVE FL 2 STAUNTON, VA 24401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 200 PINE ST W FL 1 WILSON, NC 27893 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.73% |
| 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 | 2.70% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY RD GREENSBORO, NC 27409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 10.28% |
| THE BENEFIT COMPANY INC5 | PO BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 9.53% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INSURANCE SER | 1425 RIVER PARK DRIVE SUITE 226 SACRAMENTO, CA 95815 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 9.92% |
| THE BENEFIT COMPANY INC5 | PO BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 29.11% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 125 N CENTRAL AVE FL 2 STAUNTON, VA 24401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $965 | — | $965 | 15.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 200 PINE ST W FL 1 WILSON, NC 27893 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $247 | $247 | 3.84% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 248 | 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. | 264 | $2.1M |
| Dental(2 contracts, 2 carriers) | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | 264 | $1.9M |
| Vision(2 contracts, 2 carriers) | BLUECROSS AND BLUESHIELD OF TENNESSEE, INC. | 264 | $1.9M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $100K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $69K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $71K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 26 | $188K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.