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| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF TEXAS EIN 36-1236610 NONE | Contract Administrator Service code 13 | — | $890K |
| SUN LIFE FINANCIAL NONE | Contract Administrator Service code 13 | ONE SUN LIFE EXECUTIVE PARK WELLESLEY HILLS, MA 02481 | $147K |
| ARMANINO, LLP EIN 94-6214841 NONE | Accounting (including auditing) Service code 10 | — | $33K |
| BRADSHAW & BICKERTON NONE | Legal Service code 29 | 5121 BEE CAVE RD SUITE 201 AUSTIN, TX 78746 | $12K |
| AMERIFLEX NONE | Contract Administrator Service code 13 | 2508 HIGHLANDER WAY, STE 200 CARROLLTON, TX 75006 | $12K |
| WILMINGTON TRUST COMPANY NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 1100 NORTH MARKET STREET WILMINGTON, DE 19890 | $10K |
| CLAIMS-X-CHANGE NONE | Contract Administrator Service code 13 | 14200 MIDWAY ROAD SUITE 106 DALLAS, TX 75244 | $4K |
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 | 925 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 928 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 298 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 25 | $649K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 526 | $74K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 925 | $82K |
| Short-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 362 | $272K |
| Long-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $271K |
| Other(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 925 | $998K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 925 | — |
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.