| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | AMERITAS LIFE INSURANCE CORP | $63K | $6K | $69K | 10.92% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $44K | $7K | $51K | 25.42% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 2.05% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1149 AMARILLO, TX 79102 | TOKIO MARINE HCC | $11K | — | $11K | 10.00% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 2.08% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21K | $3K | $24K | 25.22% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $3K | $20K | 25.30% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $2K | $19K | 25.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INSURANCE MANAGEMENT SERVICES EIN 75-2355889 TPA | Plan Administrator; Claims processing Service code 12 | 713 N TAYLOR AMARILLO, TX 79107 | $293K |
| UPSHAW INSURANCE AGENCY EIN 47-5239878 AGENT | Insurance agents and brokers Service code 22 | PO BOX 1149 AMARILLO, TX 79102 | $166K |
| MAXORPLUS EIN 75-2676894 PHARMACY BENEFIT MANAGER | Other services Service code 49 | 320 S POLK ST AMARILLO, TX 79101 | $29K |
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 | 700 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 738 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | STEALTH PARTNER GROUP | 700 | $1.4M |
| Dental | AMERITAS LIFE INSURANCE CORP | 1,328 | $629K |
| Vision | AMERITAS LIFE INSURANCE CORP | 1,328 | $629K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 824 | $76K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 488 | $295K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 824 | $77K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 44 | $96K |
| Stop-loss / reinsurancereinsurance | STEALTH PARTNER GROUP | 700 | $1.2M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 824 | $390K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,328 | — |
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.