| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARTIN R. MIRACLE3 Filed as: MARTIN R MIRACLE | 1250 WOODBRANCH PARK DR STE 300 HOUSTON, TX 77079 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $17K | — | $17K | 3.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 840 GESSNER ROAD STE 600 THREE MEMO HOUSTON, TX 77024 | DELTA DENTAL OF PENNSYLVANIA | $557 | — | $557 | 2.10% |
| MARTIN R. MIRACLE3 Filed as: MARTIN R MIRACLE | 9811 KATY FREEDWAY #500 HOUSTON, TX 77024 | LINCOLN NATIONAL LIFE INSURANCE CO | $2K | — | $2K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE CO | — | $515 | $515 | 2.49% |
| MARTIN R. MIRACLE3 Filed as: MARTIN R MIRACLE | 13926 MAPLE CLIFF LANE CYPRESS, TX 77429 | NATIONAL VISION ADMINISTRATORS LLC | $575 | — | $575 | 9.99% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 85 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 85 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 84 | $561K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 191 | $27K |
| Vision | NATIONAL VISION ADMINISTRATORS LLC | 160 | $6K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE CO | 85 | $21K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE CO | 85 | $21K |
| Other | LINCOLN NATIONAL LIFE INSURANCE CO | 85 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.