| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | HEALTH CARE SERVICE CORPORATION | $36K | $4K | $40K | 8.71% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 12.75% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $702 | $702 | 1.83% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $889 | $3K | 20.56% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $582 | $582 | 3.64% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $476 | $2K | 25.14% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $218 | $218 | 2.35% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $594 | $2K | 21.47% |
| PAYCOM PAYROLL LLC3 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $444 | $444 | 4.83% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $804 | $442 | $1K | 15.49% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $589 | $2K | 27.74% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $132 | $132 | 1.74% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $423 | $2K | 26.35% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $188 | $188 | 2.82% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $572 | $215 | $787 | 20.66% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $582 | $582 | 15.28% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 94 | $460K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 73 | $38K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $16K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.