| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203383 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN INC | $39K | — | $39K | 3.00% |
| MARK G SQUIRES3 Filed as: MARK G. SQUIRES | 645 WEST SAN ANTONIO STREET SUITE 100 NEW BRAUNFELS, TX 78130 | PRINCIPAL LIFE INSURANCE COMPANY | $99K | — | $99K | 8.04% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203383 DALLAS, TX 75320 | RELIASTAR LIFE INSURANCE COMPANY | $94K | $16K | $111K | 11.73% |
| WELLS FARGO INSURANCE SERVICES3 | 90 SOUTH CASCADE AVENUE, 2ND FLOOR COLORADO SPRINGS, CO 80903 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $36K | — | $36K | 4.95% |
| CLINTON GOTCHER3 | 109 CASA LOMA CIRCLE GEORGETOWN, TX 78633 | HUMANA INSURANCE COMPANY | $86K | — | $86K | 15.00% |
| CLINTON GOTCHER3 | 109 CASA LOMA CIRCLE GEORGETOWN, TX 78633 | TRANSAMERICA | $104K | — | $104K | 23.48% |
| DENNIS M PETERSON3 Filed as: DENNIS M. PETERSON | PO BOX 1703 BOERNE, TX 78006 | TRANSAMERICA | $7K | — | $7K | 1.52% |
| CLINTON GOTCHER3 | 109 CASA LOMA CIRCLE GEORGETOWN, TX 78633 | UNION SECURITY INSURANCE COMPANY | $99K | — | $99K | 40.74% |
| C DEAVEN BENEFITS3 | 714 SEYMOUR DRIVE FRISCO, TX 75033 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.74% |
| J SHANNON SHEPPARD3 | 4843 VALLEY VON WAY ARLINGTON, TN 38002 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.23% |
| MJ INSURANCE3 Filed as: GUDALUPE DENNIS AND VARIOUS AGENTS | 7723 LONGS PEAK DRIVE RIVERSIDE, CA 92509 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.23% |
| TRACY HENSON TUTOR3 | 1042 BURSLEM COVE CORDOVA, TN 38018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.14% |
| LES MILLER3 | 2249 INDUSTRIAL BOULEVARD ABILENE, TX 79602 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.12% |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALES | 11677 SANDPIPER COURT MORENO VALLEY, CA 92557 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.06% |
| JOAN TERRELL3 | 610 WHIPPOORWILL DRIVE CANYON LAKE, TX 78133 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.06% |
| CLINTON GOTCHER3 | 109 CASA LOMA CIRCLE GEORGETOWN, TX 78633 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $190 | — | $190 | 9.43% |
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 | 4,393 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 57 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,450 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 2,495 | $3.0M |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE | 10,382 | $551K |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 4,553 | $948K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,811 | $1.2M |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,811 | $1.2M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 312 | $2.0M |
| Other(7 contracts, 7 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 4,553 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,382 | — |
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.