| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACE BENEFIT PARTNERS, INC.3 | 1990 N. CALIFORNIA BLVD, STE 900 WALNUT CREEK, CA 94596 | ANICO | $13K | — | $13K | 7.00% |
| TFG FINANCIAL GROUP BENEFITS LLC3 | 806 BROOK HOLLOW DRIVE SHREVEPORT, LA 71105 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.55% |
| ROGER LAPHAM3 | 303 SUGARBERRY CIRCLE HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $348 | — | $348 | 1.04% |
| 3B VENTURE GROUP INC3 Filed as: 3B VENTURE GROUP, INC. | 832 MALLARD TRAIL MURPHY, TX 75094 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $222 | — | $222 | 0.66% |
| CLARA VICE3 Filed as: CLARA L VICE | 14902 ALDERWICK SUGARLAND, TX 77498 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $179 | — | $179 | 0.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | P.O. BOX 983 HOUSTON, TX 77001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 0.49% |
| NANCY LAPHAM3 | 303 SUGARBERRY CIRCLE HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | — | $115 | 0.34% |
| MARYSOL N. CALVILLO3 Filed as: MARYSOL N CALVILLO | 5026 LONGLANE DRIVE HOUSTON, TX 77084 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | — | $115 | 0.34% |
| VANESSA MARIA WARNER3 | 8209 HEATHERBROOK CIRCLE HAUGHTON, LA 71037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.27% |
| SANTIAGO OCHOA3 | 2120 EL PASEO, UNIT 308 HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.18% |
| VERA ANN PAREDES3 | 1414 RICHEY STREET PASADENA, TX 77502 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.12% |
| BRIAN TATES3 | 146 MOOR ROAD SHREVEPORT, LA 71106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.07% |
| BRUCE D AKERS3 | 2383 CALYPSO LANE LEAGUE CITY, TX 77573 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| ROSS LAPHAM3 | 2247 KINGS TRAIL KINGWOOD, TX 77339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| TFG FINANCIAL GROUP BENEFITS LLC3 Filed as: TFG FINANCIAL GROUP | 806 BROOK HOLLOW DRIVE SHREVEPORT, LA 71105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $634 | — | $634 | 6.23% |
| TFG FINANCIAL GROUP BENEFITS LLC3 Filed as: TFG FINANCIAL GROUP BENEFITS, LLC | 806 BROOK HOLLOW DRIVE SHREVEPORT, LA 71105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $948 | $555 | $2K | 23.79% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $278 | $278 | 4.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INSURANCE MANAGEMENT SERVICES EIN 75-2355889 THIRD PARTY ADMINISTRATO | Plan Administrator; Claims processing Service code 12 | 731 N TAYLOR AMARILLO, TX 79107 | $30K |
| CIGNA HEALTH AND INS CO EIN 59-1031071 SERVICE PROVIDER | Other services Service code 49 | PO BOX 645014 CINCINNATI, OH 06002 | $16K |
| TFG FINANCIAL GROUP BENEFITS EIN 61-1588503 INSURANCE AGENT | Insurance agents and brokers Service code 22 | 1754 EAST 70TH STREET SHREVEPORT, LA 71105 | $5K |
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 | 80 | 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) | 80 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ACE BENEFIT PARTNERS, INC. | 79 | $184K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 77 | $10K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 77 | $10K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 79 | $40K |
| Prescription drug | ACE BENEFIT PARTNERS, INC. | 79 | $184K |
| Stop-loss / reinsurancereinsurance | ANICO | 79 | $185K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 79 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.