| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $79K | — | $79K | 12.25% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY | 2443 SIR BARTON WAY STE 400 LEXINGTON, KY 40509 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$4 | — | -$4 | -0.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS CAPITAL INC. | 18050 SATURN LANE HOUSTON, TX 77058 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$12 | — | -$12 | -0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE & ACCIDENT INSURANCE | $3K | $84 | $3K | 5.15% |
| HOUSTON NORMAN HAMILTON3 | 7310 LOVE CREEK MISSOURI CITY, TX 77459 | COLONIAL LIFE & ACCIDENT INSURANCE | $2K | $1K | $3K | 5.04% |
| DEBRA KAY GAPP3 | 20302 STONE FALLS CT CYPRESS, TX 77433 | COLONIAL LIFE & ACCIDENT INSURANCE | $1K | $479 | $2K | 2.75% |
| DARIN POTTS3 | 100 DETERING ST APT 2128 HOUSTON, TX 77007 | COLONIAL LIFE & ACCIDENT INSURANCE | $688 | $680 | $1K | 2.42% |
| BOWLES INSURANCE SERVICES LLC3 | 147 W WADING POND CIRCLE TOMBALL, TX 77375 | COLONIAL LIFE & ACCIDENT INSURANCE | $535 | $361 | $896 | 1.58% |
| VALERIE MOZELLE ORONA-VICTORIA3 | 2119 6TH AVE NORTH TEXAS CITY, TX 77590 | COLONIAL LIFE & ACCIDENT INSURANCE | $680 | — | $680 | 1.20% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON LLC | 18050 SATURN LANE HOUSTON, TX 77058 | COLONIAL LIFE & ACCIDENT INSURANCE | $399 | — | $399 | 0.70% |
| VERA ANN PAREDES3 | 1414 S RICHEY ST PASADENA, TX 77502 | COLONIAL LIFE & ACCIDENT INSURANCE | $384 | $10 | $394 | 0.70% |
| DUDLEY HERRERA3 | 10502 KINGSTON CREEK LN CYPRESS, TX 77433 | COLONIAL LIFE & ACCIDENT INSURANCE | $309 | $56 | $365 | 0.64% |
| MARY REBECCA BOWLES3 | 147 W WADING POND CIRCLE TOMBALL, TX 77375 | COLONIAL LIFE & ACCIDENT INSURANCE | $146 | $45 | $191 | 0.34% |
| BELINDA ZARATE3 | 10134 WATERSTONE DR HOUSTON, TX 77042 | COLONIAL LIFE & ACCIDENT INSURANCE | $155 | — | $155 | 0.27% |
| WAYNE JAMES PITRIE | 9737 BEVLYN DR HOUSTON, TX 77025 | COLONIAL LIFE & ACCIDENT INSURANCE | $127 | $3 | $130 | 0.23% |
| JOE ANTHONY RODRIGUEZ3 | 902 DIPPING LANE HOUSTON, TX 77076 | COLONIAL LIFE & ACCIDENT INSURANCE | $106 | — | $106 | 0.19% |
| CARLA DIANNE MOFFATT3 | P.O. BOX 1320 FRIENDSWOOD, TX 77549 | COLONIAL LIFE & ACCIDENT INSURANCE | $97 | $1 | $98 | 0.17% |
| LINDA CANTU3 | 902 WEST 12TH STREET FREEPORT, TX 77541 | COLONIAL LIFE & ACCIDENT INSURANCE | $60 | — | $60 | 0.11% |
| JOSEPH WILLIAM BAKER3 | 10622 DESERT SPRINGS CIR HOUSTON, TX 77095 | COLONIAL LIFE & ACCIDENT INSURANCE | $45 | — | $45 | 0.08% |
| CHRISTOPHER D SALGE3 | 9519 GODSTONE LN SPRING, TX 77379 | COLONIAL LIFE & ACCIDENT INSURANCE | $35 | — | $35 | 0.06% |
| ALYSSA MARIE WYBLE3 | 2780 NORTHERN DR LEAGUE CITY, TX 77573 | COLONIAL LIFE & ACCIDENT INSURANCE | $32 | — | $32 | 0.06% |
| BRIDGETTE JORDAN | 1610 BUCKWOOD CT FRESNO, TX 77545 | COLONIAL LIFE & ACCIDENT INSURANCE | $21 | — | $21 | 0.04% |
| CARTER BENEFITS SOLUTIONS LLC3 Filed as: CARTER BENEFIT SOLUTIONS LLC | 22411 WILDWOOD GROVE DR KATY, TX 77450 | COLONIAL LIFE & ACCIDENT INSURANCE | $7 | — | $7 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | P.O. BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE CO | $7K | — | $7K | 15.00% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL LLC | 1925 FREDERICA ST OWENSBORO, KY 42301 | UNITED OF OMAHA LIFE INSURANCE CO | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE & ACCIDENT INSURANCE | $2K | $32 | $2K | 4.37% |
| HOUSTON NORMAN HAMILTON3 | 7310 LOVE CREEK MISSOURI CITY, TX 77459 | COLONIAL LIFE & ACCIDENT INSURANCE | $610 | $341 | $951 | 2.26% |
| DEBRA KAY GAPP3 | 20302 STONE FALLS CT CYPRESS, TX 77433 | COLONIAL LIFE & ACCIDENT INSURANCE | $370 | $164 | $534 | 1.27% |
| VALERIE MOZELLE ORONA-VICTORIA3 | 2119 6TH AVE NORTH TEXAS CITY, TX 77590 | COLONIAL LIFE & ACCIDENT INSURANCE | $526 | — | $526 | 1.25% |
| DARIN POTTS3 | 100 DETERING ST APT 2128 HOUSTON, TX 77007 | COLONIAL LIFE & ACCIDENT INSURANCE | $247 | $244 | $491 | 1.17% |
| BOWLES INSURANCE SERVICES LLC3 | 147 W WADING POND CIRCLE TOMBALL, TX 77375 | COLONIAL LIFE & ACCIDENT INSURANCE | $181 | $122 | $303 | 0.72% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON LLC | 18050 SATURN LANE HOUSTON, TX 77058 | COLONIAL LIFE & ACCIDENT INSURANCE | $252 | — | $252 | 0.60% |
| VERA ANN PAREDES3 | 1414 S RICHEY ST PASADENA, TX 77502 | COLONIAL LIFE & ACCIDENT INSURANCE | $226 | $6 | $232 | 0.55% |
| BELINDA ZARATE3 | 10134 WATERSTONE HOUSTON, TX 77042 | COLONIAL LIFE & ACCIDENT INSURANCE | $105 | — | $105 | 0.25% |
| JOE ANTHONY RODRIGUEZ3 | 902 DIPPING LN HOUSTON, TX 77076 | COLONIAL LIFE & ACCIDENT INSURANCE | $104 | — | $104 | 0.25% |
| LINDA CANTU3 | 902 WEST 12TH STREET FREEPORT, TX 77541 | COLONIAL LIFE & ACCIDENT INSURANCE | $94 | — | $94 | 0.22% |
| CARLA DIANNE MOFFATT3 | P.O. BOX 1320 FRIENDSWOOD, TX 77549 | COLONIAL LIFE & ACCIDENT INSURANCE | $86 | $1 | $87 | 0.21% |
| MARY REBECCA BOWLES3 | 147 W WADING POND CIRCLE TOMBALL, TX 77375 | COLONIAL LIFE & ACCIDENT INSURANCE | $64 | $20 | $84 | 0.20% |
| DUDLEY HERRERA3 | 10502 KINGSTON CREEK LN CYPRESS, TX 77433 | COLONIAL LIFE & ACCIDENT INSURANCE | $65 | $12 | $77 | 0.18% |
| ALYSSA MARIE WYBLE3 | 2780 NORTHERN DR LEAGUE CITY, TX 77573 | COLONIAL LIFE & ACCIDENT INSURANCE | $28 | — | $28 | 0.07% |
| WAYNE JAMES PITRIE | 9737 BEVLYN DR HOUSTON, TX 77025 | COLONIAL LIFE & ACCIDENT INSURANCE | $23 | — | $23 | 0.05% |
| BRIDGETTE JORDAN3 | 1610 BUCKWOOD CT FRESNO, TX 77545 | COLONIAL LIFE & ACCIDENT INSURANCE | $18 | — | $18 | 0.04% |
| CARTER BENEFITS SOLUTIONS LLC3 Filed as: CARTER BENEFIT SOLUTIONS LLC | 22411 WILDWOOD GROVE DR KATY, TX 77450 | COLONIAL LIFE & ACCIDENT INSURANCE | $4 | — | $4 | 0.01% |
| LORA MARIE WATSON3 | PO BOX 1663 MAGNOLIA, TX 77353 | COLONIAL LIFE & ACCIDENT INSURANCE | $2 | — | $2 | 0.00% |
| BRUCE D AKERS3 | 2383 CALYPSO LANE LEAGUE CITY, TX 77573 | COLONIAL LIFE & ACCIDENT INSURANCE | $1 | — | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | P.O BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE CO | $5K | $3K | $8K | 22.73% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2443 SIR BARTON WAY STE 400 LEXINGTON, KY 40509 | UNITED OF OMAHA LIFE INSURANCE CO | — | — | $0 | 0.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 1925 FREDERICA ST OWENSBORO, KY 42301 | UNITED OF OMAHA LIFE INSURANCE CO | — | — | $0 | 0.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON LLC | 18050 SATURN LN STE 200 HOUSTON, TX 77058 | UNITED OF OMAHA LIFE INSURANCE CO | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | — | $4K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | P.O. BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE CO | $802 | $369 | $1K | 21.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 | Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Float revenue; Participant communication; Claims processing; Named fiduciary Service code 12 | — | $51K |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 187 | $643K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 187 | $643K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 187 | $643K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 169 | $42K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 161 | $46K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 44 | $25K |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE | 169 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.