Form 5500 · Employee benefit plan · MURFREESBORO, TN
OLD TIME POTTERY, INC.
Public Form 5500 records show how OLD TIME POTTERY, INC. (MURFREESBORO, TN) structures its employee benefits. Its broker of record is ERIC JACOBSON. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC. and 6 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 62-1249062 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. | Health | 160 | December | $42,678 |
| MADISON NATIONAL LIFE | Health | 43 | December | $8,567 |
| DELTA DENTAL OF TENNESSEE | Dental | 349 | December | $6,873 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 90 | December | $3,499 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 63 | December | $3,005 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 47 | December | $2,116 |
| VISION SERVICE PLAN | Vision | 219 | December | $1,252 |
Questions
Who is OLD TIME POTTERY, INC.'s benefits broker?
Per its most recent Form 5500 Schedule A, OLD TIME POTTERY, INC.'s broker of record is ERIC JACOBSON.
What insurance carrier does OLD TIME POTTERY, INC. use?
OLD TIME POTTERY, INC.'s benefit plan is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC., among 7 disclosed carriers.
When does OLD TIME POTTERY, INC.'s group plan renew?
The most recent Schedule A policy period for OLD TIME POTTERY, INC. ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from OLD TIME POTTERY, INC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.