| 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 | — | — | $0 | 0.00% |
| 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 | — | $3K | 4.35% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAN INSURANCE AGENCY INC | 500W 13TH STREET FORT WORTH, TX 76102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.72% |
| 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 | 3.81% |
| HIGGINBOTHAM INS AGENCY INC3 | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.25% |
| HIGGINBOTHAM INS AGENCY INC3 | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $897 | $897 | 4.84% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM AGENCY INSURANCE AGENE | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $662 | $662 | 4.35% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM AGENCY INSURANCE AGENC | 500 W 13TH STREET FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| HIGGINBOTHAM INS AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $862 | — | $862 | 9.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Float revenue; Contract Administrator; Named fiduciary; Other commissions; Direct payment from the plan; Claims processing; Other services; Participant communication Service code 12 | — | $34K |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 163 | $304K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $59K |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 152 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 186 | $34K |
| Short-term disability(4 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 186 | $122K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $29K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.