| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ORIGIN INSURANCE AGENCY LLC3 Filed as: ORIGIN INSURANCE AGENCY, LLC | — | BLUECROSS BLUESHIELD OF TEXAS | $31K | — | $31K | 4.64% |
| MJ INSURANCE3 Filed as: VARIOUS BROKERS | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28K | $8K | $36K | 33.51% |
| ORIGIN INSURANCE AGENCY LLC3 | 600 ROUND ROCK WEST STE 502 ROUND ROCK, TX 78681 | DEARBORN LIFE INSURANCE COMPANY | $784 | — | $784 | 10.08% |
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 | 64 | 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) | 65 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 85 | $677K |
| Dental | BLUECROSS BLUESHIELD OF TEXAS | 85 | $677K |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 44 | $8K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 87 | $108K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 85 | $677K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 87 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 87 | — |
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.