| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBC BENEFITS LTD3 | 2409 FOREST PARK BLVD FORT WORTH, TX 76110 | BLUE CROSS BLUE SHIELD OF TEXAS | $0 | $3K | $3K | 0.31% |
| GBC BENEFITS LTD3 | 2409 FOREST PARK BLVD FLOOR 2 FORT WORTH, TX 76110 | UNION SECURITY INSURANCE COMPANY | $27K | $3K | $31K | 13.39% |
| GBC BENEFITS LTD3 Filed as: GBC BENEFITS, LTD | 2409 FOREST PARK BLVD FORT WORTH, TX 76110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 29.77% |
| ROBERT SHEPARD COOPER3 | PO BOX 609 SANGER, TX 76266 | CONTINENTAL AMERICAN INSURANCE COMPANY | $128 | $0 | $128 | 0.67% |
| MARCO JOE KLIMEK3 Filed as: MARCO J KLIMEK | 1501 LBJ FREEWAY STE 660 FARMERS BRANCH, TX 75234 | CONTINENTAL AMERICAN INSURANCE COMPANY | $111 | $0 | $111 | 0.58% |
| DEREK P SMITH3 | 11609 MARION ROAD SANGER, TX 76266 | CONTINENTAL AMERICAN INSURANCE COMPANY | $105 | $0 | $105 | 0.55% |
| JOHN M JOHNSON3 | 2150 W NW HWY SUITE 114 GRAPEVINE, TX 76051 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | $0 | $24 | 0.13% |
| TAMMI LAVOICE COOPER3 Filed as: TAMMI L COOPER | PO BOX 609 SANGER, TX 76266 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | $0 | $23 | 0.12% |
| DONAA LEHRMANN3 | 4515 WILDWOOD CIR GRANBURY, TX 76049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | $0 | $22 | 0.11% |
| MARY L WILLIAMS3 | 1102 STEVENS ST. BRIDGEPORT, TX 76426 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | $0 | $22 | 0.11% |
| SHELLY WIEGAND3 | 2607 ARMATRA DING DR CEDAR PARK, TX 78613 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | $0 | $8 | 0.04% |
| T ALLEN HOWDESHELL3 Filed as: T. ALLEN HOWDESHELL | 2400 STATE HIGHWAY 121 APT 2403 EULESS, TX 76039 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | $0 | $6 | 0.03% |
| ZACHARY EUGENE VICKERS3 Filed as: ZACHARY K. JOHNSON | 4600 N 5TH MCALLEN, TX 78504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | $0 | $3 | 0.02% |
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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 30 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 217 | $925K |
| Dental | UNION SECURITY INSURANCE COMPANY | 165 | $231K |
| Vision | UNION SECURITY INSURANCE COMPANY | 165 | $231K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 165 | $231K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 165 | $231K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 165 | $231K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS | 217 | $925K |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 165 | $250K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.