| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8511 S SAM HOUSTON PKWY E FLOOR 2 HOUSTON, TX 77075 | HEALTH CARE SERVICE CORPORATION | $15K | $0 | $15K | 2.60% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | PO BOX 908 FORT WORTH, TX 76101 | HEALTH CARE SERVICE CORPORATION | $11K | $0 | $11K | 1.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 8511 S SAM HOUSTON PKWY E HOUSTON, TX 77075 | HARTFORD LIFE AND ACCIDENT | $6K | $0 | $6K | 6.97% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 5.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2 PIERCE PLACE 21ST FL ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | $0 | $967 | $967 | 1.21% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INS AGENCY INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | HARTFORD LIFE AND ACCIDENT | $0 | $206 | $206 | 0.26% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INS AGENCY INC | PO BOX 948 HENRIETTA, NY 14467 | HARTFORD LIFE AND ACCIDENT | $25 | $0 | $25 | 0.03% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | PO BOX 908 FORT WORTH, TX 76101 | ACE USA GROUP | $1K | $0 | $1K | 3.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8511 S SAM HOUSTON PKWY E FLOOR 2 HOUSTON, TX 77075 | ACE USA GROUP | $1K | $0 | $1K | 3.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8511 S SAM HOUSTON PKWY E FLOOR 2 HOUSTON, TX 77075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $759 | $0 | $759 | 5.52% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | PO BOX 908 FORT WORTH, TX 76101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $514 | $103 | $617 | 4.49% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $103 | $0 | $103 | 0.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $95 | $95 | 0.69% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | PO BOX 908 FORT WORTH, TX 76101 | ACE USA GROUP | $459 | $0 | $459 | 3.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 8511 S SAM HOUSTON PKWY E FLOOR 2 HOUSTON, TX 77075 | ACE USA GROUP | $459 | $0 | $459 | 3.69% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 105 | $587K |
| Dental | ACE USA GROUP | 94 | $37K |
| Vision | ACE USA GROUP | 79 | $12K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 160 | $94K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 57 | $80K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 57 | $80K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.