| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANCO INS. SVC. OF BRYAN COLLEGE STA3 Filed as: ANCO INSURANCE SERVICES | 2505 E MISSOURI AVE EL PASO, TX 79903 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 6.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 4.81% |
| ANCO INS. SVC. OF BRYAN COLLEGE STA3 Filed as: ANCO INSURANCE SERVICES | 2505 E MISSOURI AVE EL PASO, TX 79903 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | — | $22K | 9.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD, 14TH FLOOR CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 6.88% |
| PROFESSIONAL ENROLLMENT CONCEPTS3 Filed as: PROFESSIONAL ENROLLMENT | CONCEPTS, INC. 6200 SAVOY STE. 345 HOUSTON, TX 77036 | ALLSTATE | $35K | — | $35K | 26.77% |
| ALLISON A WISE3 | 2801 WATERFALL DR., #143 HOUSTON, IL 77056 | ALLSTATE | $6K | — | $6K | 4.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 2505 E MISSOURI AVE EL PASO, TX 79903 | ALLSTATE | $4K | — | $4K | 2.98% |
| ALLEN COMMODORE BAKER3 | 6200 SAVOY DR SUITE 345 HOUSTON, TX 77036 | ALLSTATE | $3K | — | $3K | 2.32% |
| BRYAN INGLIS3 | 6122 GARDEN LAKES LANE SUGARLAND, TX 77479 | ALLSTATE | $3K | — | $3K | 2.23% |
| WILLIAM PARKS3 | 3788 RICHMOND AVE., APT. 1419 HOUSTON, TX 77046 | ALLSTATE | $2K | — | $2K | 1.33% |
| MARK SCOTT OSTASZEWSKI3 | 23618 ORTENSIA STREET RICHMOND, TX 77406 | ALLSTATE | $1K | — | $1K | 1.07% |
| ROSEMARY CHOI3 | 5442 MCCULLOUGH CIRCLE HOUSTON, TX 77056 | ALLSTATE | $1K | — | $1K | 1.01% |
| MARK L STEWART3 | 11511 NORMONT DR HOUSTON, TX 77070 | ALLSTATE | $1K | — | $1K | 0.94% |
| BENEFIT TECHNOLOGIES LLC3 | 8833 PERIMETER PARK BLVD STE 801 JACKSONVILLE, FL 32216 | ALLSTATE | $939 | — | $939 | 0.72% |
| DALLAS MORENO3 | 6200 SAVOY DR SUITE 345 HOUSTON, TX 77036 | ALLSTATE | $857 | — | $857 | 0.66% |
| WILLIAM MONROE PARKS3 | 7922 WESTGLEN DR HOUSTON, TX 77063 | ALLSTATE | $364 | — | $364 | 0.28% |
| TOM BRANDA3 | 8000 RESEARCH FOREST DRIVE SUITE 115 - 163 THE WOODLANDS, TX 77382 | ALLSTATE | $339 | — | $339 | 0.26% |
| KYLE MATTHEW CLEMENT3 Filed as: KYLE MATHEW CLEMENT | 3229 INDIAN TRAIL FLOWER MOUND, TX 75022 | ALLSTATE | $186 | — | $186 | 0.14% |
| JAMES RICE3 | 5749 SEA BREEZE LN FT WORTH, TX 76135 | ALLSTATE | $180 | — | $180 | 0.14% |
| RUBEN RODRIGUEZ3 | 13333 WEST RD APT 1225 HOUSTON, TX 77041 | ALLSTATE | $137 | — | $137 | 0.11% |
| TRINIDAD ROSALES3 | 477 BROOKHOLLOW NEW BRAUNFELS, TX 78132 | ALLSTATE | $91 | — | $91 | 0.07% |
| JENNIFER WAY WILCOX3 | 408 E. COLLEGE ST FREDERICKSBURG, TX 78624 | ALLSTATE | $19 | — | $19 | 0.01% |
| BRANDON PENKO3 | 6503 BRITTANY PARK LANE RICHMOND, TX 77406 | ALLSTATE | $6 | — | $6 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD., 12TH FLOOR CHICAGO, IL 60604 | ALLSTATE | $2 | — | $2 | 0.00% |
| ANCO INS. SVC. OF BRYAN COLLEGE STA3 Filed as: ANCO INSURANCE SERVICES | 2505 E MISSOURI AVE EL PASO, TX 79903 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 6.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 4.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $179 | — | $179 | 0.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 ADMINISTRATIVE SERVICES | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $467K |
| CIGNA | Direct payment from the plan; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing; Named fiduciary; Participant communication; Other services Service code 12 | — | $0 |
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 | 921 | 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) | 921 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 196 | $282K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 624 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 921 | $233K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,478 | $493K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,478 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.