Form 5500 · Employee benefit plan · HUNTSVILLE, TN
TENNIER INDUSTRIES, INC.
The filing calls this plan TENNIER INDUSTRIES, INC. WELFARE PLAN.
TENNIER INDUSTRIES, INC. of HUNTSVILLE, TN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is RICK METZELDER. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC. and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 13-2887383 · plan 501 · plan year 2023, filed Jul 30, 2024
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, dental, vision and life; the largest, with BLUECROSS BLUESHIELD OF TENNESSEE, INC., covers 137 people.
Reported premium across the insured contracts is $794,706, with $50,397 in disclosed broker commissions — about 6.3% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
RICK METZELDER is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BLUECROSS BLUESHIELD OF TENNESSEE, INC., AMERICAN UNITED LIFE INSURANCE COMPANY, BENEFIT INTELLIGENCE and SYMETRA LIFE INSURANCE COMPANY. BLUECROSS BLUESHIELD OF TENNESSEE, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. | Health, Dental, Vision | 137 | Jan 1, 2024 | $768,482 | $47,037 |
| AMERICAN UNITED LIFE INSURANCE COMPANY | Life | 192 | Jan 1, 2024 | $17,947 | $2,692 |
| SYMETRA LIFE INSURANCE COMPANY | Life | 223 | Jan 1, 2024 | $2,201 | $534 |
| BENEFIT INTELLIGENCE | — | 109 | Jan 1, 2024 | $6,076 | $134 |
Premium and claims on this contract
BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 122058. For the contract year on this filing, the carrier reported $768,482 in premium earned and $882,473 in claims incurred. Dividing one by the other gives 115%.
- BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 122058 reported $177,569 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
How this plan compares
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