| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | 500 W. 13TH STREET FORT WORTH, TX 76102 | BLUE CROSS BLUE SHIELD OF TEXAS | $71K | — | $71K | 5.09% |
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY INC. | 500 W. 13TH STREET FORT WORTH, TX 76102 | UNITED CONCORDIA INSURANCE COMPANY | $10K | — | $10K | 11.00% |
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY INC. | 500 W. 13TH STREET FORT WORTH, TX 76102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.00% |
| AMERICAP INSURANCE GROUP LLC | P.O. BOX 1388 ADDISON, TX 75001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1K | $7K | 15.40% |
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY INC. | 500 W. 13TH STREET FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $303 | $2K | 4.98% |
| VICTOR T MALVEAUX SR Filed as: VICTOR T MALVEAUX SR. | 130 COOL BROOK DRIVE RED OAK, TX 75154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.36% |
| KAREN TYLER-DUNN | 714 SEYMOUR DR. FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $875 | $52 | $927 | 2.16% |
| JEFFERY BELFOURE | 2601 SCOTT AVE. FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | $693 | $918 | 2.14% |
| BARBARA ANN BASTON | 5401 MANSEL LANE FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $792 | $84 | $876 | 2.04% |
| JENNIFER RICHARDS | 2601 SCOTT AVE. FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $152 | $185 | 0.43% |
| GARY FANCHER INSURANCE PLLC | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | $25 | $144 | 0.34% |
| AMERICAP INSURANCE GROUP LLC Filed as: AMERICAP INSURANCE GROUP, LLC | P.O. BOX 1388 ADDISON, TX 75001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $614 | $4K | 11.33% |
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY INC. | 500 W. 13TH STREET FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $159 | $1K | 3.75% |
| VICTOR T MALVEAUX SR Filed as: VICTOR T MALVEAUX SR. | 130 COOL BROOK DRIVE RED OAK, TX 75154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $867 | — | $867 | 2.38% |
| JEFFERY BELFOURE | 2601 SCOTT AVE. FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $181 | $557 | $738 | 2.03% |
| KAREN TYLER-DUNN | 714 SEYMOUR DR. FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $554 | $24 | $578 | 1.59% |
| BARBARA ANN BASTON | 5401 MANSEL LANE FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $7 | $78 | 0.21% |
| GARY FANCHER INSURANCE PLLC | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $2 | $13 | 0.04% |
| BROKER NOT PROVIDED Filed as: NO BROKER | — | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 12.77% |
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 | 250 | 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) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 250 | $1.4M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 285 | $93K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 270 | $24K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $156K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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.