| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 | 2125 YGNACIO VALLEY RD STE 200 WALNUT CREEK, CA 94598 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $30K | — | $30K | 2.38% |
| GUSTAVO DANIEL GEVARA3 Filed as: GUSTAVO GEVARA | 25306 SANDY TRACE LANE KATY, TX 77494 | AFLAC | $13K | $381 | $13K | 17.83% |
| JEREMY CONGO3 | 20315 PALOMAR POINTE DR CYPRESS, TX 77433 | AFLAC | $997 | — | $997 | 1.35% |
| CARLOS D ESPINOSA3 Filed as: CARLOS ESPINOSA | 17103 VERDE PARK LANE CYPRESS, TX 77433 | AFLAC | $367 | $71 | $438 | 0.59% |
| DAWN TOWNS3 | 23242 LIDSTONE POINT CT KATY, TX 77494 | AFLAC | $360 | — | $360 | 0.49% |
| MARYANN MCBRAYER3 | 10818 WYSALL CLIFF CT HOUSTON, TX 77064 | AFLAC | $159 | — | $159 | 0.21% |
| EDWARD SCARBROUGH3 | 3007 RIVER FOREST DR RICHMOND, TX 77406 | AFLAC | $123 | — | $123 | 0.17% |
| JEFFREY C WEST3 Filed as: JEFFREY WEST | 2466 FM 1697 LEDBETTER, TX 78946 | AFLAC | $108 | — | $108 | 0.15% |
| HEATHER NEDDEAU3 | 20518 N BLUE HYACINTH DR CYPRESS, TX 77433 | AFLAC | $102 | — | $102 | 0.14% |
| TRUDY MARCELLINO3 | 14718 PLANTATION OAK DR HOUSTON, TX 77068 | AFLAC | $77 | — | $77 | 0.10% |
| CHERYL SCARBROUGH3 | 3007 RIVER FOREST DR RICHMOND, TX 77406 | AFLAC | $43 | — | $43 | 0.06% |
| THERESA CHAMBLISS3 | 2059 PINE RIVER DR KINGWOOD, TX 77339 | AFLAC | $26 | — | $26 | 0.04% |
| FOUNDATION RISK PARTNERS CORP3 | 4634 GULFSTARR DESTIN, FL 32541 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| FOUNDATION RISK PARTNERS CORP3 | 4634 GULFSTARR DESTIN, FL 32541 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| GUSTAVO DANIEL GEVARA3 | 25306 SANDY TRACE LN KATY, TX 77494 | AFLAC | $3K | $286 | $4K | 16.38% |
| CARLOS D ESPINOSA3 | 17827 PUMPKIN VINE DR HOCKLEY, TX 77447 | AFLAC | $253 | $47 | $300 | 1.36% |
| JEREMY CONGO3 | 20315 PALOMAR POINTE DR CYPRESS, TX 77433 | AFLAC | $195 | — | $195 | 0.89% |
| TRUDY MARCELLINO3 Filed as: TRUDY MACELLINO | 14718 PLANTATION OAK DR HOUSTON, TX 77068 | AFLAC | $7 | — | $7 | 0.03% |
| GUSTAVO DANIEL GEVARA3 | 25306 SANDY TRACE LN KATY, TX 77494 | AFLAC | $2K | — | $2K | 28.66% |
| JEREMY CONGO3 | 20315 PALOMAR POINTE DR CYPRESS, TX 77433 | AFLAC | $235 | — | $235 | 3.06% |
| CARLOS D ESPINOSA3 Filed as: CARLOS ESPINOSA | 17103 VERDE PARK LANE CYPRESS, TX 77433 | AFLAC | $68 | — | $68 | 0.88% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 9700 ORMSBY STATION ROAD SUITE 200 LOUISVILLE, KY 40223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $867 | — | $867 | 15.01% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $289 | $289 | 5.00% |
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 | 149 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 211 | $1.3M |
| Dental | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 211 | $1.3M |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 211 | $1.3M |
| Life insurance(4 contracts, 2 carriers) | AFLAC | 149 | $109K |
| Short-term disability(3 contracts) | AFLAC | 76 | $104K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 50 | $28K |
| Other(5 contracts, 2 carriers) | AFLAC | 149 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.