| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERSTATE INSURANCE AGENCY3 | PO BOX 1249 PERRYTON, TX 79070 | COMPANION LIFE INSURANCE COMPANY | — | $84K | $84K | 12.12% |
| INSURANCE MANAGEMENT SERVICES5 | 731 N TAYLOR AMARILLO, TX 79107 | COMPANION LIFE INSURANCE COMPANY | — | $21K | $21K | 3.02% |
| INTERSTATE INSURANCE AGENCY3 | PO BOX 1249 PERRYTON, TX 79070 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| INSURANCE MANAGEMENT SERVICES5 | 731 N TAYLOR AMARILLO, TX 79107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INSURANCE MANAGEMENT SERVICES EIN 75-2355889 THIRD PARTY ADMINISTRATOR | Plan Administrator; Claims processing Service code 12 | 731 N TAYLOR AMARILLO, TX 79107 | $138K |
| TELADOC DIRECT EIN 04-3705970 TELEMEDICINE | Other services Service code 49 | P.O. BOX 123417 DALLAS, TX 75312 | $14K |
| PCM RX MANAGEMENT EIN 27-3463867 RX MANAGEMENT | Other services Service code 49 | P.O. BOX 34446 RENO, NV 89533 | $7K |
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 | 258 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE COMPANY | 258 | $692K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $29K |
| Prescription drug | COMPANION LIFE INSURANCE COMPANY | 258 | $692K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.