| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 0.96% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAN INSURANCE AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $2K | $5K | 7.83% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $220 | — | $220 | 0.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 7.55% |
| HIGGINBOTHAM INS AGENCY INC3 | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 7.48% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.86% |
| HIGGINBOTHAM INS AGENCY INC3 | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $970 | $970 | 4.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $963 | $963 | 6.63% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM AGENCY INSURANCE AGENC | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $688 | $688 | 4.74% |
| HIGGINBOTHAM INS AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 12.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Contract Administrator; Other services; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan Service code 12 | — | $69K |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 167 | $272K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 91 | $67K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 159 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $34K |
| Short-term disability(4 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 164 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 84 | $26K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 91 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.