| 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. | $39K | $119 | $39K | 2.85% |
| GUSTAVO DANIEL GEVARA3 Filed as: GUSTAVO GEVARA | 25306 SANDY TRACE LANE KATY, TX 77494 | AFLAC | $9K | $332 | $9K | 15.38% |
| CARLOS D ESPINOSA3 Filed as: CARLOS ESPINOSA | 17103 VERDE PARK LANE CYPRESS, TX 77433 | AFLAC | $820 | $77 | $897 | 1.51% |
| DAWN TOWNS3 | 23242 LIDSTONE POINT CT KATY, TX 77494 | AFLAC | $379 | — | $379 | 0.64% |
| MARYANN MCBRAYER3 | 10818 WYSALL CLIFF CT HOUSTON, TX 77064 | AFLAC | $149 | — | $149 | 0.25% |
| EDWARD SCARBROUGH3 | 3007 RIVER FOREST DR RICHMOND, TX 77406 | AFLAC | $130 | — | $130 | 0.22% |
| HEATHER NEDDEAU3 | 20518 N BLUE HYACINTH DR CYPRESS, TX 77433 | AFLAC | $102 | — | $102 | 0.17% |
| JEFFREY C WEST3 Filed as: JEFFREY WEST | 2466 FM 1697 LEDBETTER, TX 78946 | AFLAC | $99 | — | $99 | 0.17% |
| TRUDY MARCELLINO3 | 14718 PLANTATION OAK DR HOUSTON, TX 77068 | AFLAC | $82 | — | $82 | 0.14% |
| THERESA CHAMBLISS3 | 2059 PINE RIVER DR KINGWOOD, TX 77339 | AFLAC | $50 | — | $50 | 0.08% |
| CHERYL SCARBROUGH3 | 3007 RIVER FOREST DR RICHMOND, TX 77406 | AFLAC | $38 | — | $38 | 0.06% |
| KRISTEN EDGE3 Filed as: KRISTEN SPINOSO | 6028 YALE CT NORTH RIDGEVILLE, OH 44039 | AFLAC | $13 | — | $13 | 0.02% |
| THOMAS WESLEY3 | 837 MOSS CANYON DR AMHERST, OH 44001 | AFLAC | $10 | — | $10 | 0.02% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INSURANCE AGENCY INC | 9404 WOODCHIP LANE BROADVIEW HEIGHTS, OH 44147 | AFLAC | $4 | — | $4 | 0.01% |
| FOUNDATION RISK PARTNERS CORP3 | 9700 ORMSBY STATION RD STE 200 LOUISVILLE, KY 40223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| FOUNDATION RISK PARTNERS CORP3 | 9700 ORMSBY STATION RD STE 200 LOUISVILLE, KY 40223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GUSTAVO DANIEL GEVARA3 | 25306 SANDY TRACE LN KATY, TX 77494 | AFLAC | $8K | $185 | $8K | 31.30% |
| CARLOS D ESPINOSA3 | 17827 PUMPKIN VINE DR HOCKLEY, TX 77447 | AFLAC | $967 | $43 | $1K | 3.88% |
| TRUDY MARCELLINO3 Filed as: TRUDY MACELLINO | 14718 PLANTATION OAK DR HOUSTON, TX 77068 | AFLAC | $5 | — | $5 | 0.02% |
| 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 | $1K | — | $1K | 15.00% |
| GUSTAVO DANIEL GEVARA3 | 25306 SANDY TRACE LN KATY, TX 77494 | AFLAC | $616 | $58 | $674 | 10.54% |
| DAWN TOWNS3 Filed as: DAWN MARIE TOWNS | 23242 LIDSTONE POINT CT KATY, TX 77494 | AFLAC | $103 | — | $103 | 1.61% |
| CARLOS D ESPINOSA3 | 17827 PUMPKIN VINE DR HOCKLEY, TX 77447 | AFLAC | $55 | $13 | $68 | 1.06% |
| JOHANN Y RESTITUYO3 | 19403 ALTON SPRINGS DR CYPRESS, TX 77433 | AFLAC | $53 | — | $53 | 0.83% |
| HEATHER NEDDEAU3 | 20518 N BLUE HYACINTH DR CYPRESS, TX 77433 | AFLAC | $10 | — | $10 | 0.16% |
| GUSTAVO DANIEL GEVARA3 | 25306 SANDY TRACE LN KATY, TX 77494 | AFLAC | $71 | — | $71 | 6.08% |
| DAWN TOWNS3 Filed as: DAWN MARIE TOWNS | 23242 LIDSTONE POINT CT KATY, TX 77494 | AFLAC | $12 | — | $12 | 1.03% |
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 | 159 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 215 | $1.4M |
| Dental | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 215 | $1.4M |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 215 | $1.4M |
| Life insurance(5 contracts, 2 carriers) | AFLAC | 159 | $100K |
| Short-term disability(4 contracts) | AFLAC | 78 | $93K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 54 | $43K |
| Other(6 contracts, 2 carriers) | AFLAC | 159 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.