| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLSPRING INSURANCE AGENCY INC3 Filed as: WELLSPRING INSURANCE AGENCY, INC. | — | BLUE CROSS BLUE SHIELD OF TEXAS | $8K | $2K | $10K | 1.27% |
| FRANK SWINGLE & ASSOCIATES, INC3 | — | BLUE CROSS BLUE SHIELD OF TEXAS | $6K | — | $6K | 0.71% |
| WELLSPRING INSURANCE AGENCY INC3 Filed as: WELLSPRING INSURANCE AGENCY, INC. | 124 OLD TOWN BOULEVARD NORTH SUITE 100 ARGYLE, TX 76226 | FIDELIY SECURITY LIFE INSURANCE COMPANY | $471 | — | $471 | 3.48% |
| WELLSPRING INSURANCE AGENCY INC3 | 124 OLD TOWN BOULEVARD NORTH ARGYLE, TX 76226 | BLUE CROSS BLUE SHIELD OF TEXAS | — | $6K | $6K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC FT WORT | 1000 NORTH CENTRAL EXPRESSWAY SUITE 1200 DALLAS, TX 75231 | BLUE CROSS BLUE SHIELD OF TEXAS | $3K | — | $3K | — |
| CLARKADAMSON, LLC3 | 3603 FM 51 GAINESVILLE, TX 76240 | BLUE CROSS BLUE SHIELD OF TEXAS | $3K | — | $3K | — |
| FRANK SWINGLE & ASSOCIATES, INC3 Filed as: FRANK SWINGLE & ASSOCIATES INC | 13760 NOEL ROAD SUITE 600 DALLAS, TX 75240 | BLUE CROSS BLUE SHIELD OF TEXAS | $1K | — | $1K | — |
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 | 155 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 84 | $799K |
| Dental | BLUE CROSS BLUE SHIELD OF TEXAS | 84 | $799K |
| Vision | FIDELIY SECURITY LIFE INSURANCE COMPANY | 169 | $14K |
| Life insurance | BLUE CROSS BLUE SHIELD OF TEXAS | 106 | $0 |
| Short-term disability | BLUE CROSS BLUE SHIELD OF TEXAS | 106 | $0 |
| Long-term disability | BLUE CROSS BLUE SHIELD OF TEXAS | 106 | $0 |
| Other | BLUE CROSS BLUE SHIELD OF TEXAS | 106 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.