| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - GBS | 1900 W LOOP S SUITE 1600 HOUSTON, TX 77027 | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | $42K | — | $42K | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 0.43% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $69 | $69 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 3.98% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $183 | $183 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 W LOOP S SUITE 1600 HOUSTON, TX 77027 | AETNA LIFE INSURANCE COMPANY | $1K | — | $1K | 0.44% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN WORTHAM & SON LLP | PO BOX 301598 DALLAS, TX 75303 | AETNA LIFE INSURANCE COMPANY | $95 | — | $95 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPYREAN EIN 20-3029813 NONE | Contract Administrator Service code 13 | — | $174K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Contract Administrator Service code 13 | — | $142K |
| BSWIFT EIN 36-4391310 NONE | Contract Administrator Service code 13 | — | $123K |
| UNITED HEALTHCARE EIN 95-3939697 NONE | Contract Administrator Service code 13 | — | $119K |
| AETNA DENTAL EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $66K |
| CALLAN LLC EIN 94-2192581 NONE | Investment advisory (plan) Service code 27 | — | $35K |
| WELLS FARGO BANK EIN 94-2984229 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $33K |
| NORTHERN TRUST EIN 36-1561860 NONE | Trustee (directed) Service code 25 | — | $29K |
| MCCONNELL & JONES LLP EIN 76-0488832 NONE | Accounting (including auditing) Service code 10 | — | $15K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5,908 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,908 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 5,048 | $8.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 790 | $237K |
| Vision | VISION SERVICE PLAN | 4,415 | $725K |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,469 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,048 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.