| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | ONE CENTRY CENTRE 1750 E GOFL RD, STE 1100 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $45K | $2K | $47K | 3.51% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L.S. & ASSOCIATES INSURANCE | 1973 OAK TREE CV HERNANDO, MS 38632 | BLUECROSS BLUESHIELD OF ILLINOIS | $5K | — | $5K | 0.36% |
| INSURICA, INC.3 Filed as: INSURICA TX INSURANCE SRVS | 4802 KINSEY DR TYLER, TX 75703 | BLUE CROSS BLUE SHIELD OF TEXAS | $55K | $1K | $56K | 5.94% |
| ROGERS BENEFIT GROUP INC3 Filed as: WILLIAM GRADY ROGERS | 123 TBD WICHITA FALLS, TX 76301 | BLUE CROSS BLUE SHIELD OF TEXAS | $6K | — | $6K | 0.60% |
| BRIDGE CREEK SERVICES, LLC3 | 500 WEST 13TH STREET FORT WORTH, TX 76102 | BLUE CROSS BLUE SHIELD OF TEXAS | $5K | — | $5K | 0.55% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY, STE 2000 CARROLLTON, TX 750071960 | BLUE CROSS BLUE SHIELD OF TEXAS | $14K | — | $14K | 4.50% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L.S. & ASSOCIATES INSURANCE | 1973 OAK TREE CV HERNANDO, MS 38632 | BLUECROSS BLUESHIELD OF ILLINOIS | $10K | — | $10K | 5.62% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | ONE CENTURY CENTRE 1750 E GOLF ROAD SCHAUMBURG, SC 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $0 | $2K | $2K | 1.39% |
| INSURICA, INC.3 Filed as: INSURICA TX INSURANCE SERVICES INC | 2400 N GLENVILLE DR STE B125 RICHARDSON, TX 75082 | DEARBORN LIFE INSURANCE COMPANY | $9K | $4K | $13K | 16.80% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L S & ASSOCIATES INSURANCE CO | 1973 OAK TREE CV HERNANDO, MS 38632 | DEARBORN LIFE INSURANCE COMPANY | $999 | — | $999 | 1.26% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | ONE CENTURY CENTRE 1750 E GOFL RD, STE 1100 SCHAUMBURG, IL 60173 | DEARBORN LIFE INSURANCE COMPANY | $7K | $395 | $8K | 11.31% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L S & ASSOCIATES INS CONSULTANTS | 1973 OAK TREE CV HERNANDO, MS 38632 | DEARBORN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.27% |
| INSURICA, INC.3 Filed as: INSURICA TX INSURANCE SERVICES | SUITE 225W GREAT HILLS PLAZA 9600 GREAT HILLS TRAIL AUSTIN, TX 78759 | FIDELITY SECURITY LIFE | $3K | — | $3K | 11.89% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L S & ASSOCIATES INS CONSULTANTS | 1973 OAK TREE CV HERNANDO, MS 38632 | FIDELITY SECURITY LIFE | $876 | — | $876 | 3.11% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | ONCE CENTURY CENTRE 1750 E GOFL RD, STE 1100 SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE COMPANY (EYEMED) | $927 | — | $927 | 3.71% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN INSURANCE SERVICES | PO BOX 2569 BELLAIRE, TX 77402 | FIDELITY SECURITY LIFE COMPANY (EYEMED) | $199 | $655 | $854 | 3.42% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 NORTH MARTINGALE ROAD SCHAUMBURG, IA 60173 | FIDELITY SECURITY LIFE COMPANY (EYEMED) | $780 | — | $780 | 3.12% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L.S. & ASSOCIATES | 1973 OAK TREE CV HERNANDO, MS 38632 | FIDELITY SECURITY LIFE COMPANY (EYEMED) | $320 | — | $320 | 1.28% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 750071960 | HUMANA DENTAL INSURANCE COMPANY | $1K | — | $1K | 7.95% |
| LS & ASSOCIATES INS CONSULTANTS INC3 Filed as: L S & ASSOCIATES INS CONSULTANTS | 1973 OAK TREE CV HERNANDO, MS 38632 | HUMANA DENTAL INSURANCE COMPANY | $322 | — | $322 | 2.05% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 752511800 | HUMANA DENTAL INSURANCE COMPANY | $0 | $162 | $162 | 1.03% |
| TIMA TAMZEN3 Filed as: TIMA, TAMZEN | PO BOX 860 HONOLULU, HI 96808 | USABLE LIFE | $2K | — | $2K | 399.83% |
| SANCHEZ, MARY3 | PO BOX 860 HONOLULU, HI 96808 | USABLE LIFE | — | $2 | $2 | 0.34% |
| YAMASHIRO, NAN3 | PO BOX 860 HONOLULU, HI 96808 | USABLE LIFE | — | $1 | $1 | 0.17% |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 360 | $2.9M |
| Dental(6 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 360 | $2.8M |
| Vision(3 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 308 | $168K |
| Life insurance(2 contracts) | DEARBORN LIFE INSURANCE COMPANY | 204 | $148K |
| Short-term disability(3 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 204 | $149K |
| Long-term disability(2 contracts) | DEARBORN LIFE INSURANCE COMPANY | 204 | $148K |
| Other(3 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 204 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.