| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UPSHAW INSURANCE AGENCY INC.3 | — | BLUECROSS BLUESHIELD OF TEXAS | $33K | $0 | $33K | 0.89% |
| STACY ERVIEN3 Filed as: STACY KNIGHT & ASSOCIATES, INC. | — | BLUECROSS BLUESHIELD OF TEXAS | $22K | $0 | $22K | 0.59% |
| NEELY CRAIG & WALTON LLP3 | PO BOX 506 AMARILLO, TX 79105 | METROPOLITAN LIFE INSURANCE COMPANY | $26K | $0 | $26K | 9.74% |
| NEELY CRAIG & WALTON LLP3 Filed as: NEELY, CRAIG & WALTON | PO BOX 506 AMARILLO, TX 79105 | VISION SERVICE PLAN | $2K | — | $2K | 3.54% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY | 801 S FILLMORE STE 300 AMARILLO, TX 79101 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 5.27% |
| JILL MATHEWS INSURANCE AGENT3 | PO BOX 2665 AMARILLO, TX 79105 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 4.74% |
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 | 1,303 | 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) | 1,303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 1,303 | $3.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,323 | $263K |
| Vision | VISION SERVICE PLAN | 291 | $56K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 505 | $32K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 505 | $32K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TEXAS | 1,303 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,323 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.