| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBC BENEFITS LTD3 Filed as: GBC BENEFITS, LTD | 2409 FOREST PARK BLVD FORT WORTH, TX 76110 | BLUE CROSS BLUE SHIELD OF TEXAS | $33K | $0 | $33K | 3.98% |
| ROGER BENEFIT GROUP INC3 Filed as: ROGER BENEFIT GROUP | 1701 RIVER RUN FORT WORTH, TX 76107 | BLUE CROSS BLUE SHIELD OF TEXAS | $8K | $0 | $8K | 1.00% |
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH STREET FORT WORTH, TX 76107 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $622 | $6K | 8.68% |
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH STREET FORT WORTH, TX 76107 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 20.20% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $59 | $59 | 0.10% |
| TAMMARA LYNN COOK3 | 153 PRAIRIE CREEK CIRCLE PRINCETON, TX 75407 | AFLAC | $1K | $0 | $1K | 7.43% |
| MARY B SALMON3 | 286 DIAMOND RD WHITEWRIGHT, TX 75491 | AFLAC | $284 | $0 | $284 | 1.76% |
| CANDICE RENEE TREVINO3 | 12594 S STATE HIGHWAY 121 TRENTON, TX 75490 | AFLAC | $208 | $0 | $208 | 1.29% |
| SUZETTE GOULD3 | 327 S WALNUT ST FLORENCE, AL 35630 | AFLAC | $137 | $0 | $137 | 0.85% |
| AMBER DOTTS3 | 3709 FAULKNER DR ROWLETT, TX 75088 | AFLAC | $123 | $0 | $123 | 0.76% |
| SUZANNE LEWIS3 | 7116 RIPLEY ST MCKINNEY, TX 75071 | AFLAC | $106 | $0 | $106 | 0.66% |
| JOHN DEE MAULDIN3 | 5798 TOAD HOLW THE COLONY, TX 75056 | AFLAC | $101 | $0 | $101 | 0.63% |
| SCARLETT CLARK3 | 397 WESTERN MEADOWS DURANT, OK 74701 | AFLAC | $53 | $0 | $53 | 0.33% |
| GAY M HUNDLEY3 | 620 TAYLOR TRL MURPHY, TX 75094 | AFLAC | $38 | $0 | $38 | 0.24% |
| ROBERT PERRY EVANS JR3 | 1031 SADDLEBROOK DR LUCAS, TX 75002 | AFLAC | $37 | $0 | $37 | 0.23% |
| JAMES R LAYMON3 | 919 S CARROLL BLVD STE 201 DENTON, TX 76201 | AFLAC | $26 | $0 | $26 | 0.16% |
| GAY M HUNDLEY3 | 8796 FOREST CREEK LN ANNA, TX 75409 | AFLAC | $25 | $0 | $25 | 0.15% |
| KEVIN S. RIBERA3 Filed as: KEVIN S RIBERA | 3101 BLADES CIR DURANT, OK 74701 | AFLAC | $25 | $0 | $25 | 0.15% |
| AMANDA RISNER3 | 8813 PRIEST MEADOW CT MCKINNEY, TX 75071 | AFLAC | $24 | $0 | $24 | 0.15% |
| BRETT MERLYN BIGELOW3 | 18242 N 90TH LN PEORIA, AZ 85382 | AFLAC | $23 | $0 | $23 | 0.14% |
| DAVID HANCOCK INC3 | PO BOX 423 LAVON, TX 75166 | AFLAC | $17 | $0 | $17 | 0.11% |
| SHARYL K BATHE3 | 1816 BROADWAY AVE MATTOON, IL 61938 | AFLAC | $14 | $0 | $14 | 0.09% |
| SHARYL K BATHE3 | 620 ODD FELLOW RD MATTOON, IL 61938 | AFLAC | $12 | $0 | $12 | 0.07% |
| BILLY DALE ELKINS3 | 1024 BOURLAND ROAD KELLER, TX 76248 | AFLAC | $11 | $0 | $11 | 0.07% |
| THOMAS L JEFFORDS3 Filed as: THOMAS L JEFFORDS IV | PO BOX 6191 MCKINNEY, TX 75071 | AFLAC | $11 | $0 | $11 | 0.07% |
| GARY C KLEIN3 | 3211 SAN SEBASTIAN DR CARROLLTON, TX 75006 | AFLAC | $10 | $0 | $10 | 0.06% |
| JOSHUA WORTHY3 | 2929 W MAIN ST DURANT, OK 74701 | AFLAC | $9 | $0 | $9 | 0.06% |
| JOHN M JOHNSON3 | 2150 W NORTHWEST HWY STE 114 GRAPEVINE, TX 76051 | AFLAC | $7 | $0 | $7 | 0.04% |
| SCOTT WEBB3 | 2155 W PINNACLE PEAK RD STE 205 PHOENIX, AZ 85027 | AFLAC | $6 | $0 | $6 | 0.04% |
| TIMOTHY W WORTHY JR3 | 2929 W MAIN ST DURANT, OK 74701 | AFLAC | $6 | $0 | $6 | 0.04% |
| HARVEY EDWARD MCCREARY JR3 | 273 BELLWOOD DR GARLAND, TX 75040 | AFLAC | $5 | $0 | $5 | 0.03% |
| STEVEN B KEMPTON3 | 4912 DERBYSHIRE DR MCKINNEY, TX 75070 | AFLAC | $5 | $0 | $5 | 0.03% |
| MARY L WILLIAMS3 | 1102 STEVENS ST STE 1 BRIDGEPORT, TX 76426 | AFLAC | $5 | $0 | $5 | 0.03% |
| JAMES R LAYMON3 | 625 SUGARLOAF CT HIGHLAND VILLAGE, TX 75077 | AFLAC | $3 | $0 | $3 | 0.02% |
| DONNA S POLSER3 | 1210 COUNTY ROAD 4930 LEONARD, TX 75452 | AFLAC | $3 | $0 | $3 | 0.02% |
| KENNETH MICHAEL BENNETT3 | 5826 NEW TERRITORY BLVD 730 SUGAR LAND, TX 77479 | AFLAC | $2 | $0 | $2 | 0.01% |
| SCOTT WEBB3 | 12366 W MILTON DR PEORIA, AZ 85383 | AFLAC | $2 | $0 | $2 | 0.01% |
| JEFFREY C WEST3 | 2466 FM 1697 LEDBETTER, TX 78946 | AFLAC | $1 | $0 | $1 | 0.01% |
| WILMA GALE JOHNSON3 | 4100 ELDORADO PKWY STE 100387 MCKINNEY, TX 75070 | AFLAC | $1 | $0 | $1 | 0.01% |
| BARBARA ANN MCNAUGHTON3 | 1308 NATURE WALK BLVD SW HUNTSVILLE, AL 35824 | AFLAC | $1 | $0 | $1 | 0.01% |
| JOHN M JOHNSON3 | 2150 W NORTHWEST HWY STE 114-1144 GRAPEVINE, TX 76051 | AFLAC | $1 | $0 | $1 | 0.01% |
| FRANKLIN R DAVIES3 | 201 ROYAL ABERDEEN WAY MCKINNEY, TX 75072 | AFLAC | $1 | $0 | $1 | 0.01% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 217 | $816K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 212 | $64K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 212 | $64K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 164 | $56K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 164 | $56K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 164 | $56K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 164 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.