| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES T LEE INSURANCE AGENCY3 Filed as: JAMES GREGORY SIDWELL | 1814 JUSTIN ROAD HIGHLAND VILLAGE, TX 75077 | UNITEDHEALTHCARE INSURANCE COMPANY | $163 | $27K | $27K | 3.45% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITEDHEALTHCARE INSURANCE COMPANY | $85 | $14K | $14K | 1.77% |
| DALLAS INSURANCE EXCHANGE II INC3 Filed as: DALLAS INSURANCE EXCHANGE II INC. | 15660 DALLAS PARKWAY, SUITE 500 DALLAS, TX 75248 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $58 | $6K | 0.71% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL & ASSOCIATION INSURANCE INC. | 110 CARILLON PARKWAY ST. PETERSBURG, FL 33716 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $69 | $2K | 7.34% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $501 | $106 | $607 | 2.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNION SECURITY INSURANCE COMPANY | $459 | — | $459 | 3.46% |
| JAMES G SIDWELL3 Filed as: JAMES GREG SIDWELL | P.O. BOX 66 LEWISVILLE, TX 75067 | UNION SECURITY INSURANCE COMPANY | $324 | — | $324 | 2.44% |
| JAMES G SIDWELL3 Filed as: JAMES GREG SIDWELL | P.O. BOX 66 LEWISVILLE, TX 75067 | UNITED DENTAL CARE OF TEXAS, INC. | $183 | — | $183 | 9.11% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNITED DENTAL CARE OF TEXAS, INC. | $119 | — | $119 | 5.92% |
| SIDWELL & ASSOCIATES INSURANCE3 | 1814 JUSTIN ROAD HIGHLAND VILLAGE, TX 75077 | GERBER LIFE INSURANCE COMPANY | $161 | — | $161 | 14.98% |
| JAMES G SIDWELL3 Filed as: JAMES GREG SIDWELL | P.O. BOX 66 LEWISVILLE, TX 75067 | UNITED DENTAL CARE OF MISSOURI, INC. | $433 | — | $433 | 131.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNITED DENTAL CARE OF MISSOURI, INC. | $111 | — | $111 | 33.64% |
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 | 146 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $791K |
| Dental(4 contracts, 4 carriers) | UNION SECURITY INSURANCE COMPANY | 60 | $16K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $791K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 251 | $22K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 251 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.