| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS INC. | 15305 NORTH DALLAS PKWY SUITE 1100 ADDISON, TX 75001 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $397K | $15K | $413K | 13.73% |
| BRIAN PARKER4 | PO BOX 1945 FRISCO, TX 75034 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $3K | — | $3K | 3.53% |
| INTEGRITY ASSET SERVICES LLC4 | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 2.62% |
| SOLUTIONS & BENEFITS LLC4 Filed as: SOLUTIONS BENEFITS INC. | 2510 BOOMER LANE YORKVILLE, IL 60560 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 1.67% |
| THOMPSON SUCCESS PARTNERS, INC.4 Filed as: THOMPSON SUCCESS PARTNERS INC | 4323 SW 18TH PL CAPE CORAL, FL 33914 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 1.60% |
| HASNAIN A KHAKU4 | P.O. BOX 28111 ANAHEIM HILLS, CA 92809 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $642 | — | $642 | 0.74% |
| JOHN BUSCH4 | 5515 BIRDWOOD ROAD HOUSTON, TX 77096 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $587 | — | $587 | 0.67% |
| THE SUCCESS NETWORK4 | 2221 PEACHTREE ROAD NE SUITE D 328 ATLANTA, GA 30309 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $525 | — | $525 | 0.60% |
| KENNETH L. JOHNSON4 | 17134 ASHBURY LDG SAN ANTONIO, TX 78247 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $503 | — | $503 | 0.58% |
| A SECURE YOU INC4 Filed as: A SECURE YOU INC. | 346 REIST ST. WILLIAMSVILLE, NY 14221 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $491 | — | $491 | 0.56% |
| PATRICIA A. BOLLI4 | 5902 EVENING SUN CT. RICHMOND, TX 77469 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $489 | — | $489 | 0.56% |
| THE ROEBUCK GROUP LLC4 | 4240 PORTSMOUTH BLVD SUITE 459 CHESAPEAKE, VA 23321 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $340 | — | $340 | 0.39% |
| BLUMCIA BUSINESS SOLUTIONS4 | 3440 YOUNGFIELD ST SUITE 271 WHEAT RIDGE, CO 80033 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $313 | — | $313 | 0.36% |
| STEVE P HOUSTON4 Filed as: STEVE P. HOUSTON | P.O. BOX 41 ROSEVILLE, CA 95661 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $235 | — | $235 | 0.27% |
| JULIE GERSHON4 | 11 PADDOCK STREET WILMINGTON, MA 01887 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $234 | — | $234 | 0.27% |
| THE NATHAN GROUP INC.4 | 817 KETTERING CLOSE ANTIOCH, TN 37013 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $204 | — | $204 | 0.23% |
| WCH CONSULTANTS LLC4 | 20118 N. 67TH AVE SUITE 300-180 GLENDALE, AZ 85308 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $171 | — | $171 | 0.20% |
| KEVIN C DUNN4 Filed as: KEVIN DUNN | 4120 N. FERDINAND ST. TACOMA, WA 98407 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $154 | — | $154 | 0.18% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $127 | — | $127 | 0.15% |
| BETH TAYLOR4 | 2252 BEACH DRIVE APT. 1906 GULFPORT, MS 39507 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $116 | — | $116 | 0.13% |
| THOMAS OWENS4 Filed as: THOMAS W. OWENS | P.O. BOX 781431 WICHITA, KS 67278 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $54 | — | $54 | 0.06% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $47 | — | $47 | 0.05% |
| JOSEPH HUTH4 | 11280 121ST STREET N STILLWATER, MN 55082 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $39 | — | $39 | 0.04% |
| DENISE MARTIN4 | 4414 EMERALD DR CARROLLTON, TX 75010 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $38 | — | $38 | 0.04% |
| CYNTHIA BAHR4 Filed as: CYNTHIA D. BAHR | 2008 DIAMOND RIDGE CIR CARROLLTON, TX 75010 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $38 | — | $38 | 0.04% |
| IRMA KNOX4 | 3315 DIEGO BAR CIR LAS VEGAS, NV 89117 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $29 | — | $29 | 0.03% |
| SUSIE M. SMITH4 | 501 DON VINCENTE CT. BOULDER CITY, NV 89005 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $20 | — | $20 | 0.02% |
| SUZETTE A HARRIS4 | 3714 YAUPON DRIVE GRAND PRAIRE, TX 75052 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $18 | — | $18 | 0.02% |
| WANDA HARRIS4 | 2579 HALLECK LANE TALLAHASSEE, FL 32312 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $12 | — | $12 | 0.01% |
| THE AGURS GROUP INC.4 | 1152 RANCH POINT WAY ANTIOCH, CA 94531 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $8 | — | $8 | 0.01% |
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 | 4,648 | 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) | 4,648 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 4,648 | $105K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,648 | $3.0M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,648 | $3.0M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,648 | $3.0M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,648 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,648 | — |
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.