| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 717 N HARWOOD SUITE 2500 DALLAS, TX 75201 | BLUE CROSS BLUE SHIELD OF TEXAS | $3K | — | $3K | 0.06% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES | 717 N HARWOOD SUITE 2500 DALLAS, TX 75201 | BCS | $117K | — | $117K | 15.00% |
| JEFF A MUND3 | 256 W MILL NEW BRAUNFELS, TX 78130 | METROPOLITAN LIFE INSURANCE | $60K | — | $60K | 14.23% |
| KRISTOPHER MUND3 | 256 W MILL NEW BRAUNFELS, TX 78130 | METROPOLITAN LIFE INSURANCE | $7K | — | $7K | 1.78% |
| BRANDON MUND3 | 256 W MILL NEW BRAUNFELS, TX 78130 | METROPOLITAN LIFE INSURANCE | $7K | — | $7K | 1.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF TEXAS EIN 36-1236610 CLAIMS PROCESSING | Claims processing; Contract Administrator; Plan Administrator Service code 12 | 300 EAST RANDOLPH STREET CHICAGO, IL 60601 | $189K |
| DELTA DENTAL EIN 94-2761537 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | P.O. BOX 1809 ALPHARETTA, GA 30023 | $20K |
| GILSBAR, LLC EIN 72-0519951 CLAIMS PROCESSING | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Claims processing; Non-monetary compensation; Contract Administrator; Float revenue Service code 12 | P.O. BOX 998 COVINGTON, LA 70434 | $18K |
| BOLINGER,SEGARS,GILBERT & MOSS EIN 75-0882037 AUDITOR | Accounting (including auditing) Service code 10 | 8215 NASHVILLE LUBBOCK, TX 79423 | $14K |
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 | 402 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 822 | $0 |
| Life insurance | METROPOLITAN LIFE INSURANCE | 800 | $419K |
| Long-term disability | METROPOLITAN LIFE INSURANCE | 800 | $419K |
| Stop-loss / reinsurancereinsurance | BCS | 373 | $782K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE | 800 | $436K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 973 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.