| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 601 NW LOOP 410 SUITE 325 SAN ANTONIO, TX 78216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $21K | — | $21K | 30.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BNFTS LLC | PO BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $21K | — | $21K | 30.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 601 NW LOOP 410 SUITE 325 SAN ANTONIO, TX 78216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BNFTS LLC | PO BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.88% |
| PAUL D GIESE3 | 5602 NEEDVILLE ST SAN ANTONIO, TX 78233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $847 | $7 | $854 | 8.98% |
| HORIZON BENEFITS LLC3 | 9385 MILLER LANE GARDEN RIDGE, TX 78266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $83 | $177 | 1.86% |
| GARY P QUANDT3 | 3206 YORKTOWN DR SAN ANTONIO, TX 78230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | $11 | $161 | 1.69% |
| SA GENERAL AGENCY INC3 | 9385 MILLER LANE GARDEN RIDGE, TX 78266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $84 | $144 | 1.51% |
| KELLY MELISSA RUSHING3 | 725 RIVER BLUFF DRIVE LYTLE, TX 78052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $16 | $104 | 1.09% |
| BILLY MARK ROBERSON3 | 17415 SHADY CANYON SAN ANTONIO, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $18 | $76 | 0.80% |
| PATRICIA L WEGNER3 | 5445 COUNTY ROAD 5710 DEVINE, TX 78016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.43% |
| OMAR MENDOZA3 | 26326 ROCKWALL PKWY NEW BRAUNFELS, TX 78132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $3 | $17 | 0.18% |
| LEONIDES H VILLA3 | 522 E VILLARET BLVD SAN ANTONIO, TX 78221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $1 | $16 | 0.17% |
| TROY J PALMER3 | 15534 CLOVER RDG SAN ANTONIO, TX 78248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.08% |
| N PAULINE FERRELL3 | 286 THOROUGHBRED SPRING BRANCH, TX 78070 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.06% |
| GALE SIMPSON3 | 1830 CONNIE DRIVE CANYON LAKE, TX 78133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.03% |
| LES MILLER3 | PO BOX 7079 ABILENE, TX 79608 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2 PIERCE PL 21ST FL ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 2.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | INC - KANSAS CITY TWO PIERCE PL 21ST FL ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 1.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAHER BENEFIT SERVICES INC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $3 | $3 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $254K |
| AETNA BEHAVIORAL HEALTH LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVE RSAA HARTFORD, CT 06156 | $13K |
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 | 711 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 717 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 253 | $10K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 990 | $279K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 990 | $279K |
| Life insurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 711 | $290K |
| Short-term disability(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 711 | $290K |
| Long-term disability(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 711 | $285K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY HARTFORD CT | 607 | $467K |
| Other(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 711 | $359K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 990 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.