| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GPA3 | 12770 MERIT DRIVE DALLAS, TX 75251 | TOKIO MARINE HCC | $9K | $3K | $12K | 13.60% |
| AMERICAN LIFE & CASUALTY3 Filed as: AMERICAN LIFE AND CASUALTY MKTG DIV | 11825 PENNSYLVANIA AVE CARMEL, IN 46032 | CONSECO HEALTH INSURANCE CO | $327 | — | $327 | 3.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS LLC | 1850 LOCKHILL SELMA SUITE 101 SAN ANTONIO, TX 78213 | CONSECO HEALTH INSURANCE CO | $194 | — | $194 | 2.16% |
| CHARLES M. DAVIS3 | 13007 PRINCE FOREST CT. SAN ANTONIO, TX 78230 | CONSECO HEALTH INSURANCE CO | $163 | — | $163 | 1.82% |
| PMA3 | 11825 PENNSYLVANIA ST. CARMEL, IN 46032 | CONSECO HEALTH INSURANCE CO | $143 | — | $143 | 1.59% |
| JAMES M. ANDERSON3 | 1238 CHINKAPIN PLACE FLOWER MOUND, TX 75028 | CONSECO HEALTH INSURANCE CO | $83 | — | $83 | 0.92% |
| HOME OFFICE TPA PAYS COMMISSION3 Filed as: HOME OFFICE | 11825 PENNSYLVANIA ST. CARMEL, IN 46032 | CONSECO HEALTH INSURANCE CO | $78 | — | $78 | 0.87% |
| INSURANCE RECEIVABLES 6. LLC.3 Filed as: INSURANCE RECEIVABLES 6. LLC | 8888 KEYSTONE CROSSING SUITE 1700 INDIANAPOLIS, IN 46240 | CONSECO HEALTH INSURANCE CO | $45 | — | $45 | 0.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: RICHARD S. LEE | 555 BAYVIEW DRIVE BELLEAIR, FL 33756 | CONSECO HEALTH INSURANCE CO | $17 | — | $17 | 0.19% |
| MICHAEL S DAVID3 | 5006 ABERDEEN PKWY AMARILLO, TX 79119 | CONSECO HEALTH INSURANCE CO | $9 | — | $9 | 0.10% |
| JAMES PERRY ZANDER3 Filed as: JAMES M. HOBBS | 4525 COLE AVE. APT. 1116 DALLAS, TX 75205 | CONSECO HEALTH INSURANCE CO | $1 | — | $1 | 0.01% |
| ANDREI RADIVOYEVITCH3 | 1812 WHISPER BLUFF TRAIL HINCKLEY, OH 44233 | CONSECO HEALTH INSURANCE CO | $1 | — | $1 | 0.01% |
| PAUL GRIFFIN3 | 12025 HUNTERS LAKE DR. NEW PORT RICHEY, FL 34654 | CONSECO HEALTH INSURANCE CO | $1 | — | $1 | 0.01% |
| LINDA TEETS3 | 5905 LOST OAKS DRIVE CARMEL, IN 46033 | CONSECO HEALTH INSURANCE CO | $1 | — | $1 | 0.01% |
| CATTO & CATTO BENEFITS GROUP LLP3 Filed as: CATTO & CATTO BENEFITS GRP LLP | 106 S ST MARY'S ST SUITE 800 SAN ANTONIO, TX 78205 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $826 | — | $826 | 13.47% |
| SHARON K CAREW3 | 2907 ELK RIVER TRAIL BULVERDE, TX 78163 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $596 | — | $596 | 9.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER VOLUNTARY BENEFITS LLC | P.O. BOX 71542 CHICAGO, IL 606951542 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $366 | — | $366 | 5.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $73 | — | $73 | 1.19% |
| SHARON ANN COBB3 | P.O. BOX 842 PFLUGERVILLE, TX 78691 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | — | $29 | 0.47% |
| CORPORATE PLAN ADMINISTRATORS3 Filed as: CORPORATE PLAN ADMS INC | 307 RIDGE BLUFF SAN ANTONIO, TX 78216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP & PENSION ADMINISTRATORS, INC EIN 75-1617587 BENEFIT ADMINISTRATOR | Other services; Claims processing; Plan Administrator Service code 12 | — | $241K |
| CATTO & CATTO BENEFITS, LLP EIN 74-2765358 BROKER | Insurance agents and brokers Service code 22 | — | $85K |
| GUNN GP, LLC EIN 74-3013501 OWNED BY PLAN SPONSOR | Other fees Service code 99 | — | $78K |
| DIXON HUGHES GOODMAN LLP EIN 56-0747981 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| CLARK HILL STRASBURGER PLC NONE | Legal; Direct payment from the plan Service code 29 | 2301 BROADWAY STREET SAN ANTONIO, TX 78215 | $9K |
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 | 544 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 549 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,301 | $545K |
| Vision | AVESIS INSURANCE INCORPORATED | 724 | $43K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,301 | $553K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,301 | $545K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,301 | $545K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 547 | $968K |
| Other(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,301 | $653K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,301 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.