| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FT. WORTH, TX 76101 | METROPOLITAN LIFE INSURANCE COMPANY | $115K | $53K | $169K | 6.76% |
| MADISON BENEFITS GROUP INC3 | 5151 SAN FELIPE 17TH FLOOR HOUSTON, TX 77056 | BLUECROSS BLUESHIELD OF TEXAS | $67K | — | $67K | 2.89% |
| MADISON BENEFITS GROUP INC | 5151 SAN FELIPE 17TH FLOOR HOUSTON, TX 77056 | UNITED HEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | 5151 SAN FELIPE 17TH FLOOR HOUSTON, TX 77056 | BLUECROSS BLUESHIELD OF HAWAII | — | — | $0 | 0.00% |
| MADISON BENEFITS GROUP INC | 5151 SAN FELIPE 17TH FLOOR HOUSTON, TX 77056 | UNITED HEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FT. WORTH, TX 76101 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $9K | $18K | 5.38% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FT. WORTH, TX 76101 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $5K | $9K | 7.23% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | 5151 SAN FELIPE 17TH FLOOR HOUSTON, TX 77056 | HARTFORD LIFE AND ACCIDENT | $996 | — | $996 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 5151 SAN FELIPE ST FL 17 HOUSTON, TX 770563607 | $2.6M |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIMS PROCESSOR | Claims processing; Contract Administrator Service code 12 | 501 U.S HIGHWAY 22 BRIDGEWATER, NJ 08807 | $124K |
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 | 7,375 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 7,375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUECROSS BLUESHIELD OF HAWAII | 267 | $749K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 9,355 | $374K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 7,376 | $2.5M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 547 | $127K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 8,981 | $1.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 6,540 | $335K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,355 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.