| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHAMBURGER AGENCY INC3 | 12215 QUAKER AVE LUBBOCK, TX 794247560 | HEALTH CARE SERVICE CORPORATION | $71K | $4K | $75K | 2.64% |
| SHAMBURGER AGENCY INC3 | 12215 QUAKER AVE LUBBOCK, TX 794247560 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $0 | $14K | 12.22% |
| SHAMBURGER AGENCY INC3 | 12215 QUAKER AVE LUBBOCK, TX 794247560 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $17K | $0 | $17K | 15.15% |
| ZACHARY GALBRAITH3 Filed as: ZACHARY L. GALBRAITH | 7021 KEWANEE AVE SUITE 2-102 LUBBOCK, TX 79424 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | -$1 | $0 | -$1 | -0.00% |
| ROSS LEE SHAMBURGER3 Filed as: ROSS SHAMBURGER | 12215 QUAKER AVE LUBBOCK, TX 794247560 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.99% |
No Schedule C service providers reported on this filing.
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 591 | $2.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 297 | $115K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 294 | $20K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 307 | $111K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 307 | $111K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 307 | $111K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 307 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 591 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.