| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | BLUECROSS BLUESHIELD OF TEXAS | $46K | $2K | $48K | 2.65% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $1K | $11K | 16.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $657 | $0 | $657 | 9.91% |
| DARIN POTTS3 | 100 DETERING STREET APARTMENT 2128 HOUSTON, TX 77007 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $224 | $0 | $224 | 3.38% |
| HOWARD HOROWITZ3 Filed as: HOWARD J. HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $0 | $57 | 0.86% |
| LAURIE J BURNS3 Filed as: LAURIE JANE BURNS | 1274 BICYCLE COURT YORK, SC 29745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.27% |
| OMAR MENDOZA3 Filed as: OMAR MENDOZA AND OTHER AGENT | 26326 ROCKWALL PARKWAY NEW BRAUFELS, TX 78132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.08% |
| BILLY MARK ROBERSON3 | 19210 BOCA DEL MAR SAN ANTONIO, TX 78258 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.06% |
| TROY J PALMER3 Filed as: TROY J. PALMER | 15534 CLOVER RIDGE SAN ANTONIO, TX 78248 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.06% |
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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 249 | $1.8M |
| Dental | BLUECROSS BLUESHIELD OF TEXAS | 249 | $1.8M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 92 | $11K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $73K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $67K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 249 | $1.8M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.