| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | BLUECROSS BLUESHIELD OF TEXAS | $82K | $0 | $82K | 2.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | AETNA LIFE INSURANCE COMPANY | $41K | $0 | $41K | 19.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | UNITED CONCORDIA DENTAL PLANS OF TEXAS, INC. | $1K | $51 | $1K | 10.40% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $329 | $18 | $347 | 4.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $276 | $12 | $288 | 3.44% |
| SANTIAGO OCHOA3 | 2120 EL PASEO HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $0 | $79 | 0.94% |
| WAYNE JAMES PITRIE3 | 9737 BEVLYN DRIVE HOUSTON, TX 77025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $3 | $51 | 0.61% |
| HOWARD HOROWITZ3 Filed as: HOWARD J. HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.13% |
| MJ INSURANCE3 Filed as: TINA M. KIRKLAND AND VARIOUS AGENTS | 13575 ROLLING HILLS BEAUMOUNT, TX 77713 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.11% |
| LULA D HOTARD3 Filed as: LULA D. HOTARD | 184 SAINT CALAIS PLACE MADISONVILLE, LA 70447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.10% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $313 | $74 | $387 | 5.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $311 | $35 | $346 | 4.54% |
| WAYNE JAMES PITRIE3 | 9737 BEVLYN DRIVE HOUSTON, TX 77025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $118 | $9 | $127 | 1.67% |
| MARY REBECCA BOWLES3 | 147 WEST WADING POND CIRLCE TOMBALL, TX 77375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $45 | $62 | 0.81% |
| SANTIAGO OCHOA3 | 2120 EL PASEO HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $0 | $52 | 0.68% |
| HOWARD HOROWITZ3 Filed as: HOWARD J. HOROWITZ AND OTHER AGENTS | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.18% |
| LULA D HOTARD3 Filed as: LULA D. HOTARD | 184 SAINT CALAIS PLACE MADISONVILLE, LA 70447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.09% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $206 | $48 | $254 | 4.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $195 | $19 | $214 | 4.04% |
| MARY REBECCA BOWLES3 | 147 WEST WADING POND CIRLCE TOMBALL, TX 77375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $40 | $55 | 1.04% |
| WAYNE JAMES PITRIE3 | 9737 BEVLYN DRIVE HOUSTON, TX 77025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $3 | $44 | 0.83% |
| SANTIAGO OCHOA3 | 2120 EL PASEO HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | $0 | $39 | 0.74% |
| VERA ANN PAREDES3 | PO BOX 1283 PASADENA, TX 77501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $1 | $25 | 0.47% |
| MARIA LUGO-VALADEZ3 Filed as: MARIA LUGO-VALADEZ AND OTHER AGENTS | 11427 STANCLIFF ROAD HOUSTON, TX 77099 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.34% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $188 | $9 | $197 | 4.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $149 | $4 | $153 | 3.22% |
| SANTIAGO OCHOA3 | 2120 EL PASEO HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $0 | $46 | 0.97% |
| WAYNE JAMES PITRIE3 | 9737 BEVLYN DRIVE HOUSTON, TX 77025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $1 | $15 | 0.32% |
| MJ INSURANCE3 Filed as: VERA ANN PAREDES AND VARIOUS AGENTS | PO BOX 1283 PASADENA, TX 77501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $5 | $13 | 0.27% |
| MARIA LUGO-VALADEZ3 | 11427 STANCLIFF ROAD HOUSTON, TX 77099 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.25% |
| DONALD GRANT JAMES3 | 2706 TAMPA STREET FRIENDSWOOD, TX 77546 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.17% |
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 | 525 | 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) | 525 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 788 | $2.8M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF TEXAS, INC. | 61 | $11K |
| Vision | AETNA LIFE INSURANCE COMPANY | 606 | $207K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 606 | $207K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 606 | $207K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 606 | $207K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 788 | $2.8M |
| Other(5 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 606 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 788 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.