| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ITO LAH INC3 Filed as: ITO LAH, INC. | 2311 TEXAS DR STE 100 IRVING, TX 750627017 | BLUE CROSS BLUE SHIELD | $34K | — | $34K | 2.09% |
| CENTERSTONE INSURANCE AND FINANCIAL4 Filed as: CENTERSTONE INSURANCE & FINANCIAL | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 752511800 | BLUE CROSS BLUE SHIELD | $8K | $324 | $9K | 0.54% |
| ITO LAH INC3 Filed as: ITO LAH INC. | 2311 TEXAS DR STE 100 IRVING, TX 750627017 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | — | $17K | 14.43% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCIAL | 12404 PARK CENTRAL DR SUITE 4000S DALLAS, TX 75251 | PRINCIPAL LIFE INSURANCE COMPANY | — | $6K | $6K | 5.02% |
| VARIOUS - SEE ATTACHED4 Filed as: AFLAC | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $14K | $1K | $16K | 21.78% |
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 | 215 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 215 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD | 215 | $1.6M |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 163 | $116K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 163 | $116K |
| Short-term disability | AFLAC | 92 | $72K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 163 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.