Form 5500 · Employee benefit plan · TUSCULUM, TN
TUSCULUM UNIVERSITY
The filing calls this plan TUSCULUM UNIVERSITY EMPLOYEE BENEFIT PLAN.
Public Form 5500 records show how TUSCULUM UNIVERSITY of TUSCULUM, TN, a education employer, structures its employee benefits. Its broker of record is BENJAMIN KELLY. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC. and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 62-0484185 · plan 501 · plan year 2025, filed Jun 17, 2026
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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.
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.
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 3 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF TENNESSEE, INC., covers 219 people.
Reported premium across the insured contracts is $1,634,273, with $103,681 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.
BENJAMIN KELLY is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Two carriers split the book: BLUECROSS BLUESHIELD OF TENNESSEE, INC. and SYMETRA LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. | Health, Dental, Vision | 219 | Jan 1, 2026 | $1,522,409 | $83,273 |
| SYMETRA LIFE INSURANCE COMPANY | Life, Disability | 61 | Jan 1, 2026 | $84,628 | $13,784 |
| SYMETRA LIFE INSURANCE COMPANY | — | 61 | Jan 1, 2026 | $27,236 | $6,624 |
Premium and claims on this contract
BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 146655. For the contract year on this filing, the carrier reported $1,522,409 in premium earned and $1,648,408 in claims incurred. Dividing one by the other gives 108%.
- BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 146655 reported $288,012 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.
Other plans filed by this employer
How this plan compares
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