| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITE HILL PLAZA INC3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| INSGROUP INC3 Filed as: INSGROUP, LLC DBA K&S INSURANCE | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | EYEMED VISION CARE | $788 | $0 | $788 | 9.68% |
| WHITE HILL PLAZA INC3 Filed as: WHITE HILLS PLAZA DBA K&S INSURANCE | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | EYEMED VISION CARE | $16 | $0 | $16 | 0.20% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $641 | $0 | $641 | 14.99% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $432 | $0 | $432 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| K&S INSURANCE AGENCY BROKER | Contract Administrator Service code 13 | 2255 RIDGE ROAD SUITE 333 ROCKWALL, TX 75087 | $31K |
| BOON CHAPMAN LTD EIN 74-2305238 BOON CHAPMAN | Contract Administrator Service code 13 | — | $24K |
| BEVCAP MANAGEMENT, LLC ADMIN | Contract Administrator Service code 13 | 120 W VIRGINIA ST STE 200 MCKINNEY, TX 75069 | $22K |
| BEVCAP HEALTH CAPTIVE - NC ADMIN | Contract Administrator Service code 13 | 120 W. VIRGINIA ST STE 200 MCKINNEY, TX 75069 | $22K |
| AETNA - PPO EIN 23-2229683 ADMIN | Contract Administrator Service code 13 | — | $13K |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $39K |
| Vision | EYEMED VISION CARE | 237 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $17K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 31 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $10K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.