| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FROST INSURANCE AGENCY INC7 | 640 TAYLOR ST SUITE 1000 FORT WORTH, TX 76102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 15.00% |
| FROST INSURANCE AGENCY INC7 Filed as: FROST INSURANCE AGENCY IN 760731 | 640 TAYLOR ST SUITE 1000 FORT WORTH, TX 76102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $918 | $0 | $918 | 15.00% |
| FROST INSURANCE AGENCY INC7 Filed as: FROST INSURANCE AGENCY IN 760731 | 640 TAYLOR ST SUITE 1000 FORT WORTH, TX 76102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $877 | $0 | $877 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $174K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | P O BOX 1087 WAYSAY, WI 54402 | $92K |
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 | 176 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTPORT INSURANCE CORP | 176 | $708K |
| Dental | WESTPORT INSURANCE CORP | 176 | $708K |
| Vision | WESTPORT INSURANCE CORP | 176 | $708K |
| Life insurance(2 contracts, 2 carriers) | WESTPORT INSURANCE CORP | 176 | $753K |
| Short-term disability(2 contracts, 2 carriers) | WESTPORT INSURANCE CORP | 176 | $714K |
| Long-term disability | WESTPORT INSURANCE CORP | 176 | $708K |
| Prescription drug | WESTPORT INSURANCE CORP | 176 | $708K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORP | 176 | $708K |
| Other(2 contracts, 2 carriers) | WESTPORT INSURANCE CORP | 176 | $714K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.