| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 10.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 335 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $994 | $0 | $994 | 15.00% |
| WHITE HILL PLAZA INC3 | 2255 RIDGE ROAD STE 333 ROCKWALL, TX 75087 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $900 | $0 | $900 | 15.00% |
| COPELAND FINL SVCS INC3 | 4701 ALTAMESA BLVD STE 2M FORT WORTH, TX 76133 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $143 | $0 | $143 | 3.13% |
| BROOKS TIMOTHY D3 | 2602 RIDGE RD STE 1 ROCKWALL, TX 75087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $141 | $0 | $141 | 3.08% |
| CHARLIE MONEY INS SVCS INC3 | 3212 BARKWOOD LANE FRISCO, TX 75034 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $72 | $0 | $72 | 1.57% |
| FOUNDATION BENEFITS LLC3 | PO BOX 85 WEST, TX 76691 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $39 | $0 | $39 | 0.85% |
| PARHAM PATRICK3 | 6918 BLENHEIM DRIVE SPRING, TX 77379 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $31 | $0 | $31 | 0.68% |
| BBR & ASSOCIATES GROUP LLC3 | 8820 WILL CLAYTON PKWY SUITE F HUMBLE, TX 77338 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $31 | $0 | $31 | 0.68% |
| POOLE PAMELA K3 | 4409 SOUTHBEND DRIVE FORT WORTH, TX 76123 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6 | $0 | $6 | 0.13% |
| BROOKS TIMOTHY D3 | 2602 RIDGE RD STE 1 ROCKWALL, TX 75087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $134 | $0 | $134 | 3.52% |
| COPELAND FINL SVCS INC3 | 4701 ALTAMESA BLVD STE 2M FORT WORTH, TX 76133 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $131 | $0 | $131 | 3.45% |
| CHARLIE MONEY INS SVCS INC3 | 3212 BARKWOOD LANE FRISCO, TX 75034 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $91 | $0 | $91 | 2.39% |
| FOUNDATION BENEFITS LLC3 | PO BOX 85 WEST, TX 76691 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $41 | $0 | $41 | 1.08% |
| PARHAM PATRICK3 | 6918 BLENHEIM DRIVE SPRING, TN 77379 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | $0 | $26 | 0.68% |
| GARCIA WENDY SUSAN3 | 4408 HALE ST THE COLONY, TX 75056 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 0.18% |
| OSBURN ALFRED BEVLIE JR3 | PO BOX 1287 SHINER, TX 77984 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.05% |
| CHARLIE MONEY INS SVCS INC3 | 3212 BARKWOOD LANE FRISCO, TX 75034 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | $0 | $12 | 0.70% |
| BROOKS TIMOTHY D3 | 2602 RIDGE RD STE 1 ROCKWALL, TX 75087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 0.58% |
| COPELAND FINL SVCS INC3 | 4701 ALTAMESA BLVD STE 2M FORT WORTH, TX 76133 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | $0 | $9 | 0.52% |
| ROGER GARZA3 | 2500 WILCREST #321 HOUSTON, TX 77042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.12% |
| COPELAND FINL SVCS INC3 | 4701 ALTAMESA BLVD STE 2M FORT WORTH, TX 76133 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | $0 | $18 | 8.33% |
| BROOKS TIMOTHY D3 | 2602 RIDGE RD STE 1 ROCKWALL, TX 75087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 3.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| K&S INSURANCE AGENCY EIN 76-0663719 BROKER | Insurance services; Insurance agents and brokers Service code 22 | — | $99K |
| BOON-CHAPMAN, LTD EIN 74-2305238 TPA | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | — | $93K |
| BEVCAP MANAGEMENT, LLC EIN 26-1870141 CONSULTING | Consulting (general) Service code 16 | — | $84K |
| AETNA-PPO EIN 06-6033492 ADMINISTRATOR | Insurance services; Plan Administrator Service code 14 | — | $51K |
| BEVCAP HEALTH CAPTIVE - NC EIN 26-1870141 ADMINISTRATOR | Plan Administrator Service code 14 | — | $22K |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 247 | $140K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $18K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 295 | $45K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 65 | $31K |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 295 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.