| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMERCIAL UNDERWRITERS INC3 | — | BLUECROSS BLUESHIELD OF TEXAS | $26K | — | $26K | 2.84% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | — | BLUECROSS BLUESHIELD OF TEXAS | $9K | — | $9K | 0.96% |
| SELLORS, MICHELE3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $698 | — | $698 | 3.32% |
| KEITH LEPACK3 Filed as: KEITH, KENNETH | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $662 | — | $662 | 3.15% |
| BLANTON, LISA3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $506 | — | $506 | 2.41% |
| HARRY LORE3 Filed as: HARRY, ABBREA | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $44 | — | $44 | 0.21% |
| CANTRELL, THOMAS3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $25 | — | $25 | 0.12% |
| FLOWERS AGENCY LLC3 Filed as: FLOWERS, DEANA | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $21 | — | $21 | 0.10% |
| COLE PAPE3 Filed as: COLE, LAURA | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $19 | — | $19 | 0.09% |
| SPLAWN, BRITTANY3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $14 | — | $14 | 0.07% |
| BOURDON, MICHELLE3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $9 | — | $9 | 0.04% |
| FAIN, TRAVIS3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $6 | — | $6 | 0.03% |
| SPEISER, JENNY3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| RUSSELL L WARYE3 Filed as: RUSSELL, SAMANTHA | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| OLVERA, CAROLINE3 | — | LIBERTY NATIONAL LIFE INSURANCE COMPANY | -$758 | — | -$758 | -3.61% |
| WILMA GALE JOHNSON3 | 4100 ELDORADO PKWY STE 100387 STE 100387 MCKINNEY, TX 75070 | AFLAC | $360 | — | $360 | 2.13% |
| MICHAEL RAY ROBINS3 | 3909 SUNDEW CT PLANO, TX 75093 | AFLAC | $332 | — | $332 | 1.97% |
| H PATRICK BRUMLEY3 | 4 GLENDALE CT TROPHY CLUB, TX 76262 | AFLAC | $150 | — | $150 | 0.89% |
| SHARYL K BATHE3 | 620 ODD FELLOW RD MATTOON, IL 61938 | AFLAC | $138 | — | $138 | 0.82% |
| LEANN RENEE BRUMLEY3 | 4 GLENDALE CT TROPHY CLUB, TX 76262 | AFLAC | $104 | — | $104 | 0.62% |
| CRAIG S DAVIES3 | 401 BOYD DR APT 5106 APT 5106 GRAPEVINE, TX 76051 | AFLAC | $95 | — | $95 | 0.56% |
| TARA MCKNIGHT3 | 3909 SUNDEW CT PLANO, TX 75093 | AFLAC | $87 | — | $87 | 0.52% |
| TAMMYE DEE ISBELL3 | 132 MOCKINGBIRD LN JACKSBORO, TX 76458 | AFLAC | $78 | — | $78 | 0.46% |
| ALEXANDRIA NICOLE ARNOLD3 | 4100 ELDORADO PKWY STE 100387 STE 100387 MCKINNEY, TX 75070 | AFLAC | $55 | — | $55 | 0.33% |
| FRANKLIN R DAVIES3 | 201 ROYAL ABERDEEN WAY MCKINNEY, TX 75072 | AFLAC | $49 | — | $49 | 0.29% |
| KENNETH B ISBELL3 | 132 MOCKINGBIRD LN JACKSBORO, TX 76458 | AFLAC | $49 | — | $49 | 0.29% |
| ROBERT PERRY EVANS JR3 | 14422 COUNTY ROAD X MCLEAN, TX 79057 | AFLAC | $35 | — | $35 | 0.21% |
| GREGORY LAKE JONES3 | 433 LAS COLINAS BLVD E STE 1150 IRVING, TX 75039 | AFLAC | $29 | — | $29 | 0.17% |
| LEANN RENEE BRUMLEY3 | 4 GLENDALE COURT TROPHY CLUB, TX 76262 | AFLAC | $21 | — | $21 | 0.12% |
| GARY C KLEIN3 | 3211 SAN SEBASTIN DR CARROLLTON, TX 75006 | AFLAC | $20 | — | $20 | 0.12% |
| DAVID M COUGHLIN3 | 2220 E ROUTE 66 STE 215 GLENDORA, CA 91740 | AFLAC | $12 | — | $12 | 0.07% |
| HARVEY EDWARD MCCREARY JR3 | 273 BELLWOOD DR GARLAND, TX 75040 | AFLAC | $10 | — | $10 | 0.06% |
| RICKY POLSER3 | 1210 COUNTY ROAD 4930 LEONARD, TX 75452 | AFLAC | $4 | — | $4 | 0.02% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM C COVINGTON | 550 S WATTERS RD STE 103 STE 103 ALLEN, TX 75013 | AFLAC | $2 | — | $2 | 0.01% |
| COMMERCIAL UNDERWRITERS INC3 Filed as: COMMERCIAL UNDERWRITERS, INC | 3515 SYCAMORE SCHOOL RD STE 125.333 STE 125.333 FORT WORTH, TX 76133 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.01% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC | 5110 N 40TH STREET #234 PHOENIX, AZ 85018 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $774 | $774 | 5.00% |
| JAMES ARTHUR VOLLMER3 | 401 N CARROLL AVE STE 207 STE 207 SOUTHLAKE, TX 760926407 | PRINCIPAL LIFE INSURANCE COMPANY | $993 | — | $993 | 10.24% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 142 | $919K |
| Dental(2 contracts, 2 carriers) | AFLAC | 139 | $27K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 139 | $10K |
| Life insurance(3 contracts, 3 carriers) | LIBERTY NATIONAL LIFE INSURANCE COMPANY | 139 | $46K |
| Short-term disability | AFLAC | 19 | $17K |
| Other(3 contracts, 3 carriers) | LIBERTY NATIONAL LIFE INSURANCE COMPANY | 102 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.