| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES SOUTHWEST | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | BLUECROSS BLUESHIELD OF TEXAS | $114K | $0 | $114K | 9.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | UNKNOWN HOUSTON, TX 77046 | BLUECROSS BLUESHIELD OF TEXAS | $25K | $0 | $25K | 2.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $116K | $0 | $116K | 11.76% |
| ADP INC5 Filed as: AUTOMATIC DATA PROCESSING, INC. | PO BOX 842875 BOSTON, MA 02284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $25K | $25K | 2.54% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $19K | $19K | 1.92% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | HUMANA INSURANCE OF PUERTO RICO, INC. | $24K | $0 | $24K | 5.71% |
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 | 1,168 | 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) | 1,168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE OF PUERTO RICO, INC. | 172 | $423K |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TEXAS | 2,808 | $1.6M |
| Vision(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,968 | $1.4M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,968 | $984K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,968 | $984K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,968 | $984K |
| Prescription drug | HUMANA INSURANCE OF PUERTO RICO, INC. | 172 | $423K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,968 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,808 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.