| 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 | $10K | — | $10K | 10.00% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | PO BOX 1299 AMARILLO, TX 79105 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INSURANCE MANAGEMENT SERVICES EIN 75-2355889 THIRD PARTY ADMINISTRATOR | Claims processing; Plan Administrator Service code 12 | 731 N TAYLOR AMARILLO, TX 79107 | $80K |
| UPSHAW INSURANCE AGENCY EIN 75-2532190 INSURANCE AGENT | Insurance agents and brokers Service code 22 | 801 S FILMORE STE 300 AMARILLO, TX 79101 | $44K |
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 | 121 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INTERNATIONAL SPECIALTY UNDERWRITER INC | 121 | $278K |
| Dental | AMERITAS LIFE INSURANCE CORP | 113 | $98K |
| Vision | AMERITAS LIFE INSURANCE CORP | 113 | $98K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $29K |
| Prescription drug | INTERNATIONAL SPECIALTY UNDERWRITER INC | 121 | $278K |
| Other(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
No prospect flags tripped on this filing.