| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RANDALL SCOTT WARD3 Filed as: RANDALL WARD | 1800 W LOOP 281 SUITE 302 LONGVIEW, TX 75604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 7.50% |
| RANDALL SCOTT WARD3 | 1800 W LOOP 281 STE 302 LONGVIEW, TX 75604 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 14.53% |
| RANDALL SCOTT WARD3 | 1800 W LOOP 281 STE 302 LONGVIEW, TX 75604 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0041200 PHARMACY BENEFIT MGMT | Float revenue; Direct payment from the plan; Other fees; Claims processing Service code 12 | — | $390K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $90K |
| RANDALL SCOTT WARD BROKER | Other commissions Service code 55 | 1800 NW LOOP 281 302 LONGVIEW, TX 75604 | $14K |
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 | 69 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 152 | $182K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 152 | $152K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 152 | $152K |
| Stop-loss / reinsurancereinsurance | ZURICH NORTH AMERICAN INSURANCE COMPANY | 169 | $364K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.