| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT, LLC | — | BLUECROSS BLUESHIELD OF TEXAS | $39K | $1K | $40K | 2.86% |
| ENDEAVOR RISK ADVISORS3 Filed as: ENDEAVOR RISK ADVISORS, LLC | — | BLUECROSS BLUESHIELD OF TEXAS | $18K | — | $18K | 1.29% |
| ENDEAVOR RISK ADVISORS3 | 550 SOUTH WATTERS ROAD SUITE 149 DALLAS, TX 75013 | DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 3.27% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT, LLC | 2101 MCCULLOUGH AVENUE SUITE 210 SAN ANTONIO, TX 78212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.12% |
| ENDEAVOR RISK ADVISORS3 Filed as: ENDEAVOR RISK ADVISORS, LLC | 1601 ELM STREET SUITE 3300 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.88% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT LLC | 45 NORTHEAST LOOP 410 SUITE 690 SAN ANTONIO, TX 78216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $673 | $673 | 2.13% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT, LLC | 2101 MCCULLOUGH AVENUE SUITE 210 SAN ANTONIO, TX 78212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 13.11% |
| ENDEAVOR RISK ADVISORS3 Filed as: ENDEAVOR RISK ADVISORS, LLC | 1601 ELM STREET SUITE 3300 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.89% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT LLC | 45 NORTHEAST LOOP 410 SUITE 690 SAN ANTONIO, TX 78216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $300 | $300 | 1.98% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT, LLC | 2101 MCCULLOUGH AVENUE SUITE 210 SAN ANTONIO, TX 78212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.18% |
| ENDEAVOR RISK ADVISORS3 Filed as: ENDEAVOR RISK ADVISORS, LLC | 1601 ELM STREET SUITE 3300 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $672 | — | $672 | 4.82% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT LLC | 45 NORTHEAST LOOP 410 SUITE 690 SAN ANTONIO, TX 78216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $245 | $245 | 1.76% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT, LLC | 2101 MCCULLOUGH AVENUE SUITE 210 SAN ANTONIO, TX 78212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 13.54% |
| ENDEAVOR RISK ADVISORS3 Filed as: ENDEAVOR RISK ADVISORS, LLC | 1601 ELM STREET SUITE 3300 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $758 | — | $758 | 6.46% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT LLC | 45 NORTHEAST LOOP 410 SUITE 690 SAN ANTONIO, TX 78216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $240 | $240 | 2.05% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT, LLC | 2101 MCCULLOUGH AVENUE SUITE 210 SAN ANTONIO, TX 78212 | MUTUAL OF OMAHA INSURANCE COMPANY | $373 | — | $373 | 9.83% |
| ENDEAVOR RISK ADVISORS3 Filed as: ENDEAVOR RISK ADVISORS, LLC | 1601 ELM STREET SUITE 3300 DALLAS, TX 75201 | MUTUAL OF OMAHA INSURANCE COMPANY | $196 | — | $196 | 5.17% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPIRE RISK MANAGEMENT LLC | 45 NORTHEAST LOOP 410 SUITE 690 SAN ANTONIO, TX 78216 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $91 | $91 | 2.40% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 170 | $1.4M |
| Dental | BLUECROSS BLUESHIELD OF TEXAS | 170 | $1.4M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 149 | $52K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 149 | $52K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $32K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $27K |
| Other(5 contracts, 4 carriers) | DEARBORN LIFE INSURANCE COMPANY | 149 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.