| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NOLAN R SMITH3 | 109 BROWN DRIVE WAKE VILLAGE, TX 75501 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23K | — | $23K | 17.55% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 1.55% |
| DAVID M WILKINS3 | 1415 W RANDOL MILL RD ARLINGTON, TX 76012 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 15.95% |
| DAVID M WILKINS3 | 1415 W RANDOL MILL RD ARLINGTON, TX 76012 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 16.02% |
| NOLAN R SMITH3 | 109 BROWN DRIVE WAKE VILLAGE, TX 75501 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 31.90% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33 | — | $33 | 0.41% |
| NOLAN R SMITH3 | 1019 BROWN DRIVE WAKE VILLAGE, TX 75501 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 46.28% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | — | $12 | 0.55% |
| NOLAN R SMITH3 | 109 BROWN DRIVE WAKE VILLAGE, TX 75501 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $79 | — | $79 | 6.27% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $38 | — | $38 | 3.02% |
| NOLAN R SMITH3 | 1019 BROWN DRIVE WAKE VILLAGE, TX 75501 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $123 | — | $123 | 32.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMHEALTH EIN 41-1485369 | Insurance services Service code 23 | — | $525K |
| HEALTHSMART BENEFIT SOLUTIONS EIN 73-0985223 | Claims processing Service code 12 | — | $157K |
| PHCS | Claims processing Service code 12 | — | $36K |
| HEALTHSMART CARE MANAGEMENT EIN 36-4099199 | Claims processing Service code 12 | — | $35K |
| BOCKMON, KNIGHT & TRAYLOR INSURANCE EIN 26-1524380 | Insurance agents and brokers Service code 22 | — | $30K |
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 | 757 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 757 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 409 | $145K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 291 | $100K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $74K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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.