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Form 5500 · Employee benefit plan · CORDOVA, TN

WEST TENNESSEE FAMILY SOLUTIONS

The filing calls this plan WEST TENNESSEE FAMILY SOLUTIONS WELFARE BENEFITS PLAN.

WEST TENNESSEE FAMILY SOLUTIONS of CORDOVA, TN insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is FREDERICK J VANN. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC. and 1 other carrier. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 62-1830442 · plan 501 · plan year 2025, filed Jul 15, 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.

All participants at the start of the year
119
Active at start of year
117
Active at end of year
119
Disclosed commissions
$21,562
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — BLUECROSS BLUESHIELD OF TENNESSEE, INC.34 of 119 participants (29%)
Dentalinsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY46 of 119 participants (39%)
Visioninsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY40 of 119 participants (34%)
Lifeinsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY35 of 119 participants (29%) on the largest contract
Disabilityinsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY31 of 119 participants (26%) on the largest contract

Also declared: 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 9 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF TENNESSEE, INC., covers 34 people.

Reported premium across the insured contracts is $258,831, with $21,562 in disclosed broker commissions — about 8.3% 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.

FREDERICK J VANN is the broker of record on 1 of the 9 contracts; the rest name a different broker or none.

Two carriers split the book: BLUECROSS BLUESHIELD OF TENNESSEE, INC. and THE LINCOLN NATIONAL LIFE INSURANCE COMPANY.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
BLUECROSS BLUESHIELD OF TENNESSEE, INC.Health34Jan 1, 2026$204,081$13,520
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYLife35Jan 1, 2026$13,114$2,177
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYDental46Jan 1, 2026$13,477$1,290
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYDisability31Jan 1, 2026$8,589$1,233
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYDisability26Jan 1, 2026$7,417$1,065
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY—18Jan 1, 2026$3,513$807
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYLife118Jan 1, 2026$4,718$782
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY—12Jan 1, 2026$1,879$416
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYVision40Jan 1, 2026$2,043$272

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
WEST TENNESSEE FAMILY SOLUTIONS
EIN 62-1830442

The plan administrator is from line 3a of the main form. We publish company names only.

Reported to OSHA

Reported to OSHA for 2025: 133 employees, 0 recordable cases, 0 days away from work.

EmployeesThe company's own average for the year
133
Hours worked
277,531
Recordable cases
0
Days away from work
0

Source: OSHA Injury Tracking Application establishment data, 2025.

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