| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 9442 CAPITAL OF TEXAS HIGHWAY NORTH SUITE 950 AUSTIN, TX 78759 | BLUECROSS BLUESHIELD OF TEXAS | $83K | $5K | $88K | 2.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $2K | $14K | 12.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7 | $7 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | $2K | $15K | 15.67% |
| DAWN D STILLWELL3 Filed as: DAWN D. STILLWELL | 135 SOUTH SAGE HOLLOW DRIPPING SPRINGS, TX 78620 | AFLAC | $4K | $77 | $4K | 4.32% |
| MJ INSURANCE3 Filed as: SHELLY WIEGAND AND VARIOUS AGENTS | 2607 ARMATRADING DRIVE CEDAR PARK, TX 78613 | AFLAC | $3K | $0 | $3K | 3.47% |
| JENNIFER R THOM3 Filed as: JENNIFER R. THOM | 11704 NATRONA DRIVE AUSTIN, TX 78759 | AFLAC | $2K | $55 | $2K | 2.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2K | $0 | $2K | 2.28% |
| JEROME JEFFREY PESEK3 | 12566 MESA VERDE DRIVE AUSTIN, TX 78737 | AFLAC | $761 | $55 | $816 | 0.95% |
| JENNIFER L VERHAEGHE3 Filed as: JENNIFER L. VERHAEGHE | 3513 DUNLOP AVENUE BILLINGS, MT 59106 | AFLAC | $742 | $0 | $742 | 0.87% |
| ROSA NIDYA BARNETT3 | 12307 KLONDIKE RUSH POINT AUSTIN, TX 78726 | AFLAC | $538 | $160 | $698 | 0.81% |
| GALLAGHER BENEFIT SERVICES, INC.4 | PO BOX 95287 CHICAGO, IL 60694 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $578 | $0 | $578 | 9.98% |
| KACY LAVENDER4 | 307 SPRING CREEK MOODY, TX 76557 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $402 | $0 | $402 | 6.94% |
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 | 399 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 399 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 316 | $3.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 394 | $115K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 394 | $115K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 440 | $99K |
| Short-term disability | AFLAC | 152 | $86K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 316 | $3.0M |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 440 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.