| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 717 N HARWOOD SUITE 2500 DALLAS, TX 75201 | BLUE CROSS BLUE SHIELD OF TEXAS | $24K | $600 | $24K | 2.96% |
| SUMMIT GROUP OF VIRGINIA3 Filed as: SUMMIT GLOBAL PARTNERS OF TEXAS INC | 840 GESSNER ROD STE 600 HOUSTON, TX 23466 | PRINCIPLE LIFE INSURANCE COMPANY | $6K | — | $6K | 11.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BCH, VA 23466 | PRINCIPLE LIFE INSURANCE COMPANY | $2K | — | $2K | 3.68% |
| GARRY LYNN JOHNSON3 | 3850 E BASELINE RD STE 121 MESA, AZ 85206 | PRINCIPLE LIFE INSURANCE COMPANY | — | $1K | $1K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | ATTENTION ACCOUNTING DEPARTMENT TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | ATTENTION ACCOUNTING DEPARTMENT TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $750 | $0 | $750 | 2.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TOW PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $312 | $0 | $312 | 0.85% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE STE 1200 DALLAS, TX 75201 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $87 | $2K | 5.28% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 444 W 47TH ST SUITE 900 ATTN TELLYE HEDRICK KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $512 | $512 | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA GROUP INSURANCE | $2K | $337 | $3K | 8.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | SUITE 500 3600 AMERICAN BLVD WEST PLYMOUTH, MN 55431 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | SUITE 500 300 AMERICAN BLVD WEST MT. LAUREL, NJ 55431 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $321 | $0 | $321 | 0.99% |
| BRAND KEVIN JOSEPH3 | 5080 SPECTRUM DR STE 902W ADDISON, TX 85001 | MASSACHUSETTS MUTIAL LIFE INSURANCE COMPANY | $513 | $1 | $514 | 9.84% |
| BRAND KEVIN JOSEPH3 | 5080 SPECTRUM DR STE 902W ADDISON, TX 75001 | MASSACHUSETTS MUTIAL LIFE INSURANCE COMPANY | $319 | $3 | $322 | 6.16% |
| LEWIS GARY E3 | 5080 SPECTRUM DR STE 902W ADDISON, TX 75001 | MASSACHUSETTS MUTIAL LIFE INSURANCE COMPANY | $131 | $2 | $133 | 2.54% |
| LEWIS GARY E3 | 5080 SPECTRUM DR STE 902W ADDISON, TX 75001 | MASSACHUSETTS MUTIAL LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.04% |
| JOHNSON KEITH W3 | 7300 COLLEGE BLVD STE 215 OVERLAND PARK, KS 66210 | MASSACHUSETTS MUTIAL LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
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 | 81 | 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) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 102 | $813K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 127 | $34K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 67 | $4K |
| Life insurance(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 82 | $102K |
| Other | MASSACHUSETTS MUTIAL LIFE INSURANCE COMPANY | 10 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.