| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASCENDE, INC.3 | 2700 POST OAK BLVD SUITE 2500 HOUSTON, TX 77056 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 15.00% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $85 | $85 | 0.07% |
| GPA3 | 12770 MERIT DRIVE DALLAS, TX 75251 | AIG | $4K | — | $4K | 10.00% |
| GBC BENEFITS LTD3 Filed as: GBC BENEFITS, LTD | 2409 FOREST PARK BLVD. FORT WORTH, TX 76110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 13.16% |
| GREGORY JAMES HODGES3 Filed as: GREGORY HODGES | 5775 D GLENRIDGE DRIVE STE. 350 ATLANTA, GA 30328 | CONTINENTAL AMERICAN INSURANCE COMPANY | $437 | — | $437 | 2.48% |
| MARCO JOE KLIMEK3 | 3301 AIRPORT FREEWAY STE. 324 BEDFORD, TX 76021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $146 | — | $146 | 0.83% |
| ROBERT SHEPARD COOPER3 | PO BOX 609 SANGER, TX 76266 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | — | $45 | 0.26% |
| JOHN E CUMMINGS3 Filed as: JOHN JOHNSON | 2150 W NW HIGHWAY STE. 114 GRAPEVINE, TX 76051 | CONTINENTAL AMERICAN INSURANCE COMPANY | $42 | — | $42 | 0.24% |
| DEREK P SMITH3 | 11609 MARION ROAD SANGER, TX 76266 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36 | — | $36 | 0.20% |
| THOMAS G MONTGOMERY3 | PO BOX 231 CROWLEY, TX 76036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.07% |
| TAMMI LAVOICE COOPER3 Filed as: TAMMI L COOPER | PO BOX 609 SANGER, TX 76266 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.05% |
| DONNA D LASKOSKIE3 Filed as: DONNA LEHRMANN | 3213 EDWARDS VIEW CT APT 1728 FORT WORTH, TX 76132 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.05% |
| MARY L WILLIAMS3 | 1102 STEVENS ST BRIDGEPORT, TX 76426 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.05% |
| DAVID R FISHER3 | 2409 FOREST PARK BLVD. FORT WORTH, TX 76110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| DARRELL L HOLLEY3 | 62 PANORAMA CIRCLE TROPHY CLUB, TX 76262 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT L CLARK | 7606 UNIVERSITY AVE SUITE F LUBBOCK, TX 79423 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| CECIL RAY PARKER3 | 7606 SOUTH UNIVERSITY AVE SUITE F LUBBOCK, TX 79423 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| T ALLEN HOWDESHELL3 | 2400 STATE HIGHWAY 121 APT 2403 EULESS, TX 76039 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.03% |
| PETER B WILKINSON JR3 Filed as: PETER B WILKINSON JR. | 1408 LANCELOT AVE WOLFFORTH, TX 79382 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.03% |
| CRAIG S DAVIES3 | 2605 SAGEBRUSH DRIVE STE. 105 FLOWER MOUND, TX 75028 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| SHELLY WIEGAND3 | 1709 SAWTOOTH OAK TRL. KELLER, TX 76248 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| PETER J MACE3 | 5775 D GLENRIDGE DR. STE. 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $129 | — | $129 | 3.52% |
| GBC BENEFITS LTD3 | 2409 FOREST PARK BLVD. FORT WORTH, TX 76110 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 1.50% |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 195 | $123K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 195 | $119K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 195 | $119K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 195 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.