| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN D PETERSON3 | 1930 CORNERSTONE PLACE DR KATY, TX 77450 | BLUECROSS BLUESHIELD OF TEXAS | $56K | — | $56K | 2.24% |
| JOHN D PETERSON3 | 1930 CORNERSTONE PLACE DR KATY, TX 77450 | HUMANA INC | $9K | — | $9K | 6.21% |
| JOHN PETERSON3 | 1930 CORNERSTONE PLACE DR KATY, TX 774506704 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 13.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JOHN D PETERSON BROKER | Other commissions Service code 55 | 1930 CORNERSTONE PLACE DR KATY, TX 77450 | $64K |
| UMR INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | P.O. BOX 1087 WAUSAU, WI 554021087 | $37K |
| EYRING LEAVITT AND DRANEY PLLC EIN 26-1783184 INDEPENDENT AUDITOR | Accounting (including auditing) Service code 10 | 142 ELDRIDGE RD, STE C SUGAR LAND, TX 77478 | $8K |
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 | 447 | 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) | 447 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 447 | $2.5M |
| Dental | HUMANA INC | 196 | $141K |
| Vision | HUMANA INC | 196 | $141K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 322 | $37K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 322 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.