| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | HEALTH CARE SERVICE CORPORATION | $36K | $0 | $36K | 8.57% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 13.32% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $594 | $594 | 1.58% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $986 | $4K | 20.86% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $582 | $582 | 3.46% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $366 | $3K | 22.69% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $218 | $218 | 1.60% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 24.40% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $444 | $444 | 3.76% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $244 | $2K | 22.71% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $214 | $214 | 2.37% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $221 | $2K | 22.62% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $234 | $234 | 2.77% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $611 | $247 | $858 | 21.05% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $582 | $582 | 14.28% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $789 | $498 | $1K | — |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 92 | $423K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $38K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $17K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.