Form 5500 · Employee benefit plan · GAINESBORO, TN
TWIN LAKES TELEPHONE COOPERATIVE CORP
The filing calls this plan TWIN LAKES TELEPHONE COOPERATIVE CORP ANCILLARY.
TWIN LAKES TELEPHONE COOPERATIVE CORP of GAINESBORO, TN is a 167-participant information and media employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is SCOTT HAILE & COMPANY. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC. and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 62-0517180 · plan 501 · plan year 2025, filed Jul 28, 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.
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 6 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF TENNESSEE, INC., covers 391 people.
Reported premium across the insured contracts is $3,035,420, with $71,593 in disclosed broker commissions — about 2.4% 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.
SCOTT HAILE & COMPANY is the broker of record on all 6 contracts.
3 carriers appear on the filing, including BLUECROSS BLUESHIELD OF TENNESSEE, INC., MEDCO CONTAINMENT LIFE INSURANCE COMPANY and RELIANCE STANDARD LIFE INSURANCE COMPANY. BLUECROSS BLUESHIELD OF TENNESSEE, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Dental, Vision | 563 | Jan 1, 2026 | $369,196 | $36,920 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 262 | Jan 1, 2026 | $75,037 | $15,007 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 203 | Jan 1, 2026 | $53,450 | $10,690 |
| MEDCO CONTAINMENT LIFE INSURANCE COMPANY | Health | 136 | Jan 1, 2026 | $370,335 | $8,976 |
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. | Health | 391 | Jan 1, 2026 | $1,769,575 | $0 |
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. | Health | 136 | Jan 1, 2026 | $397,827 | $0 |
Premium and claims on these contracts
BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 146586. For the contract year on this filing, the carrier reported $1,769,575 in premium earned and $1,930,880 in claims incurred. Dividing one by the other gives 109%.
BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 146653. For the contract year on this filing, the carrier reported $397,827 in premium earned and $328,913 in claims incurred. Dividing one by the other gives 83%.
- BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 146586 reported $232,193 in retention.
- BLUECROSS BLUESHIELD OF TENNESSEE, INC., contract 146653 reported $19,891 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.
Other plans filed by this employer
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