| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 1900 WEST LOOP SOUTH SUITE 1600 HOUSTON, TX 770273205 | BLUE CROSS BLUE SHIELD OF TEXAS | $62K | $2K | $64K | 5.03% |
| BENEFITS UNLIMITED INC3 | — | ACE USA GROUP | $8K | — | $8K | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 WEST LOOP SOUTH SUITE 1600 HOUSTON, TX 77027 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 9.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 601433141 | HARTFORD LIFE AND ACCIDENT | — | $913 | $913 | 2.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 WEST LOOP SOUTH SUITE 1600 HOUSTON, TX 77027 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 601433141 | HARTFORD LIFE AND ACCIDENT | — | $681 | $681 | 2.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 WEST LOOP SOUTH SUITE 1600 HOUSTON, TX 77027 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 10.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 601433141 | HARTFORD LIFE AND ACCIDENT | — | $663 | $663 | 2.65% |
| POLARIS BENEFITS LLC3 Filed as: POLARIS BENEFIT SERVICES LLC | 13231 CHAMPION FOREST DRIVE SUITE 305 HOUSTON, TX 77069 | HARTFORD LIFE AND ACCIDENT | -$8 | — | -$8 | -0.03% |
| BENEFITS UNLIMITED INC3 | — | ACE USA GROUP | $1K | — | $1K | 10.00% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 58 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 203 | $1.3M |
| Dental | ACE USA GROUP | 241 | $83K |
| Vision | ACE USA GROUP | 132 | $14K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 187 | $25K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 88 | $27K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 310 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.