| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM- FORT WORTH, INC. | 1600 W 7TH STREET FORT WORTH, TX 76102 | UNITED HEALTHCARE INSURANCE COMPANY | $33K | $3K | $37K | 4.95% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH INC. | 1600 WEST 7TH STREET FORT WORTH, TX 76102 | ACE USA GROUP | $2K | $0 | $2K | 8.99% |
| CAROLYN ANN MCLAUGHLIN3 | 639 E TRIPP RD SUNNYVALE, TX 75182 | AFLAC | $2K | $0 | $2K | 10.87% |
| ANN K GRAVSETH3 | 4528 CEDAR BRUSH DRIVE DALLAS, TX 75229 | AFLAC | $836 | $185 | $1K | 5.26% |
| ADAM SHANE HUNDLEY3 | 620 TAYLOR TRAIL MURPHY, TX 75094 | AFLAC | $711 | $37 | $748 | 3.85% |
| GAY M HUNDLEY3 | 1416 GABLES COURT PLANO, TX 75075 | AFLAC | $524 | $37 | $561 | 2.89% |
| ROY G SHELDON3 | 6298 WILLOWGATE DALLAS, TX 75230 | AFLAC | $209 | $0 | $209 | 1.08% |
| JAMES A VANDIVER3 | 4516 LOUISVILLE DR PLANO, TX 75093 | AFLAC | $116 | $0 | $116 | 0.60% |
| ROBERT PERRY EVANS JR3 | 1031 SADDLEBROOK DR LUCAS, TX 75002 | AFLAC | $78 | $37 | $115 | 0.59% |
| JOHN DEE MAULDIN3 | 3209 PHAETON PLANO, TX 75023 | AFLAC | $98 | $0 | $98 | 0.50% |
| DAVID J KASKA3 | 1862 DENVER WEST CT #224 LAKEWOOD, CO 80401 | AFLAC | $26 | $0 | $26 | 0.13% |
| SCOTT WEBB3 | 2355 W PINNACLE PEAK RD STE 380 PHOENIX, AZ 85027 | AFLAC | $25 | $0 | $25 | 0.13% |
| VELMA E KASKA3 | 7803 EPPING LANE AUSTIN, TX 78745 | AFLAC | $15 | $0 | $15 | 0.08% |
| ANDERSON C THOMPSON3 | 4001 TRENT PINES DR NEW BERN, NC 28562 | AFLAC | $13 | $0 | $13 | 0.07% |
| FRANKLIN R DAVIES3 | 201 ROYAL ABERDEEN WAY MCKINNEY, TX 75070 | AFLAC | $9 | $0 | $9 | 0.05% |
| T ALLEN HOWDESHELL3 Filed as: ALLEN V HUNDLEY | 620 TAYLOR TRAIL MURPHY, TX 75094 | AFLAC | $4 | $0 | $4 | 0.02% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM- FORT WORTH, INC. | 1600 W 7TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH, INC. | 1600 W 7TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH, INC. | 1600 W 7TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $459 | — | $459 | 14.99% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 132 | $742K |
| Dental | ACE USA GROUP | 93 | $28K |
| Vision | AFLAC | 24 | $19K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 107 | $22K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 107 | $34K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $18K |
| Other(2 contracts, 2 carriers) | AFLAC | 107 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.