| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF TEXAS | $40K | — | $40K | 4.76% |
| THE ASHMORE AGENCY, INC.3 Filed as: THE ASHMORE AGENCY INC | — | BLUECROSS BLUESHIELD OF TEXAS | — | $12K | $12K | 1.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF TEXAS | — | $2K | $2K | 0.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1076 HIGHLAND COLONY PARKWAY SUITE 300 RIDGELAND, MS 39157 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $4K | $8K | 8.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $6K | $1K | $7K | 15.58% |
| THE ASHMORE AGENCY, INC.3 | 6102 82ND STREET #6 LUBBOCK, TX 79424 | DEARBORN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.56% |
| LAQUITA KAY CARTHEL3 Filed as: LAQUITA KAY | 4002 92ND STREET LUBBOCK, TX 79423 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 22.61% |
| KELLY S. MADDEN3 Filed as: KELLY SHAWN | 5714 YORK LUBBOCK, TX 79414 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 11.83% |
| ANGELIQUE N LILES3 Filed as: ANGELIQUE NOELLE LILES | 9101 HURON AVENUE LUBBOCK, TX 79424 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 6.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 5.56% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 182 | $848K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $87K |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 114 | $44K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 114 | $44K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 114 | $44K |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 145 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.