| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE ASHMORE AGENCY, INC.3 Filed as: THE ASHMORE AGENCY INC | — | BLUECROSS BLUESHIELD OF TEXAS | $8K | — | $8K | 1.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF TEXAS | $5K | $2K | $7K | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $5K | $2K | $6K | 20.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | P.O. BOX 95287 CHICAGO, IL 60694 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $517 | — | $517 | 10.00% |
| BENEFITSOURCE INC3 | 1804 JUAN TABO NORTHEAST ALBUQUERQUE, NM 87112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $259 | — | $259 | 5.01% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 131 | $581K |
| Dental | BLUECROSS BLUESHIELD OF TEXAS | 131 | $581K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 49 | $5K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 96 | $32K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 96 | $32K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 96 | $32K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 96 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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.