Nashville, Tennessee employer health plans: what they cost and who gets paid
Updated plan year 2024, the most recent complete year
253 employers in Nashville, Tennessee filed health plans with 100 or more participants for plan year 2024, covering 561,551 participants. They reported $120M in insurance premiums and $36M in broker commissions and fees. The median broker rate on commission-paying, fully insured medical plans was 3.3% of premium, against 3.9% across Tennessee and 3.8% nationally. Against 2023, premiums were down 14.0% and broker pay rose 5.5%.
Funding: 71 fully insured · 93 self-funded · 89 mixed. 182 of 253 plans pay at least some medical claims from the employer's own assets.
Largest employer health plans in Nashville
Nashville employers reporting the most insurance premium across every Schedule A contract, with what they paid brokers.
| Employer | Premiums | Broker pay | Participants | Top broker |
|---|---|---|---|---|
| Vanderbilt University Medical Center | $12,512,743 | — | 27,828 | Willis Towers Watson |
| Healthstream, Inc. | $10,828,275 | $147,274 | 1,077 | Lockton |
| Envision Healthcare Operating, Inc. | $6,496,243 | $1,442,018 | 17,218 | Lockton |
| Broadcast Music, Inc. | $5,788,524 | $147,552 | 628 | Willis Towers Watson |
| Bass, Berry & Sims PLC | $5,458,697 | $410,495 | 523 | Matthew B. Moraski |
| Hines Furlong Line, Inc. | $4,031,176 | $217,851 | 324 | Paul Roussel |
| Vanderbilt University | $3,437,105 | $113,045 | 5,763 | Greenleaf Benefit Advisors, LLC. |
| Oneoncology, LLC | $3,329,048 | $784,368 | 6,440 | HUB International |
| Urgent Team Holdings, Inc. | $3,297,338 | $185,483 | 676 | Lou Diaz |
| Trevecca Nazarene University | $3,296,990 | $124,611 | 338 | John Storto |
| Redwood-Slc Holdings, LLC | $3,211,279 | $108,061 | 399 | Conner Strong & Buckelew |
| YMCA of Middle Tennessee | $3,172,867 | $19,811 | 408 | HUB International |
| SVP Sewing Brands, LLC | $3,111,877 | $174,709 | 266 | Michael F. Shanahan |
| Nashville Hockey Club, LP | $2,829,717 | $135,709 | 308 | Austin L. Madison |
| Asurion LLC | $2,776,213 | $2,383,016 | 9,984 | Aon |
| Carter-Haston Real Estate Services, Inc. | $2,705,054 | $177,059 | 367 | Austin Madison |
| Parking Management Company, LLC | $2,630,658 | $156,279 | 283 | Brandon Webb |
| Pioneer College Caterers, Inc. | $2,527,333 | $91,342 | 284 | Kevin N Kelsey |
| Western Express, Inc. | $2,427,276 | $173,737 | 1,401 | Professional Ins Enrollers LLC |
| HCA Inc. | $2,072,901 | $2,505,211 | 307,593 | Acrisure |
| Concrete Pump Partners LLC | $2,070,878 | $152,414 | 234 | Meghan E. Guffee |
| Chairmans Foods Holdings, LLC | $1,868,741 | $137,534 | 339 | David L. Drummond |
| Zander Group Holdings, Inc. | $1,829,621 | $104,783 | 217 | Joseph Deyo |
| Best Brands, Inc. | $1,767,596 | $78,221 | 203 | Zander Insurance Agency |
| Amsurg, LLC | $1,622,239 | $355,885 | 100 | Lockton |
Source: DOL Form 5500 Schedule A, plan year 2024; employers are grouped by the sponsor's mailing city as filed. Self-funded employers show only stop-loss and ancillary premium.
Who gets paid
Commissions and fees reported by Nashville employers, with the number of employer plans naming each broker.
| Broker | Commissions + fees | Plans |
|---|---|---|
| Gallagher | $3,567,102 | 25 |
| Lockton | $3,155,511 | 21 |
| Aon | $3,028,563 | 13 |
| HUB International | $2,725,294 | 35 |
| OneDigital | $2,184,853 | 34 |
| Marsh McLennan Agency | $1,790,100 | 12 |
| Brown & Brown | $1,513,987 | 22 |
| Willis Towers Watson | $1,443,259 | 13 |
| Mercer | $1,258,718 | 8 |
| USI Insurance Services | $1,082,520 | 11 |
Largest medical carriers
Medical premium written for these employers.
Nashville against Tennessee and the U.S.
Medians over the same definitions on every BenefitsLedger page: commission rate on commission-paying, fully insured medical plans; broker pay per employer that disclosed any; medical premium per covered person.
| Nashville | Tennessee | United States | |
|---|---|---|---|
| Employer plans | 253 | 1,276 | 58,547 |
| Median commission rate | 3.3% (23 plans) | 3.9% | 3.8% |
| Middle half of rates | 3.0% – 4.3% | 3.3% – 5.3% | 2.7% – 5.0% |
| Median broker pay per employer | $87,816 | $82,913 | $72,628 |
| Medical premium per covered person | $5,875 | $5,747 | $7,274 |
| Plans reporting no commission | 1 | 13 | 933 |
Year over year. In plan year 2023, 248 Nashville employers reported $139M in premiums and $34M in broker pay for 480,427 participants; in 2024 it was $120M and $36M for 561,551 participants (premiums −14.0%, broker pay +5.5%).
Source: DOL Form 5500 and Schedule A, plan years 2024 and 2023, employer health plans with 100 or more participants; built October 24, 2026. Medians need at least 10 rated plans to be shown for a city. Methodology.
How much do Nashville employers pay health insurance brokers?
253 Nashville employers reported $36,141,161 in broker commissions and fees on their 2024 Form 5500 filings, 238 of them disclosing at least some compensation. Among 23 commission-paying, fully insured medical plans, the median broker rate was 3.3% of premium, 0.6 points below the Tennessee median of 3.9% and 0.5 points below the U.S. median of 3.8%. In dollars, the median Nashville employer that disclosed broker pay reported $87,816.
Which Nashville employers have the largest health plans?
By insurance premium reported for 2024, Vanderbilt University Medical Center ($13M), Healthstream, Inc. ($11M), Envision Healthcare Operating, Inc. ($6.5M) lead. 25 Nashville employers are listed on this page; every employer in the record has its own page.
Which brokers and carriers are paid the most in Nashville?
By compensation reported by Nashville employers, the largest brokers are Gallagher ($3.6M, 25 plans), Lockton ($3.2M, 21 plans), Aon ($3.0M, 13 plans). By medical premium, the largest carriers are Bluecross Blueshield of Tennessee, Inc., Cigna Health and Life Insurance Company, Blue Cross and Blue Shield of Alabama.
Are Nashville employer health plans self-funded or fully insured?
Of 253 Nashville employer plans, 71 are fully insured, 93 are self-funded and 89 mix insured and self-funded coverage. Self-funded plans report only stop-loss and ancillary contracts on Schedule A, so their premium and broker pay understate total spend.
Other cities in Tennessee
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