| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | UNITED HEALTHCARE INSURANCE COMPANY | $6K | -$33 | $6K | 11.81% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 25.03% |
| BARBARA ANN BASTON3 | 5401 MANSEL LN FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $69 | $2K | 5.99% |
| ERIC BROGAN3 Filed as: ERIC L MILLER | 8720 ELBE TRL FORT WORTH, TX 76118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $64 | $1K | 3.87% |
| VICTOR T MALVEAUX SR3 | 130 COOL BROOK DR RED OAK, TX 75154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $988 | $0 | $988 | 3.42% |
| JEFFREY BELFOURE3 | 2601 SCOTT AVE FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | $346 | $554 | 1.92% |
| JENNIFER RICHARDS3 | 2601 SCOTT AVE FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | $322 | $530 | 1.84% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DR IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $303 | $67 | $370 | 1.28% |
| KAREN TYLER-DUNN3 | 714 SEYMOUR DR FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $238 | $49 | $287 | 0.99% |
| CAROL M PASTERNAK-RIFFE3 | 247 GRAHAM DR FORNEY, TX 75126 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $46 | $248 | 0.86% |
| EAST TEXAS BUSINESS SOLUTIONS LLC3 | 641 COUNTY RD 2311 MINEOLA, TX 75773 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $58 | $79 | 0.27% |
| ANNETTE BASTON ROBINSON3 | 5401 MANSEL LN FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.09% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 22.35% |
| ERIC BROGAN3 Filed as: ERIC L MILLER | 8720 ELBE TRL FORT WORTH, TX 76118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $63 | $1K | 5.01% |
| BARBARA ANN BASTON3 | 5401 MANSEL LN FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $43 | $1K | 4.95% |
| VICTOR T MALVEAUX SR3 | 130 COOL BROOK DR RED OAK, TX 75154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $531 | $0 | $531 | 2.47% |
| JEFFERY BELFOURE3 | 2601 SCOTT AVE FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | $206 | $334 | 1.55% |
| JENNIFER RICHARDS3 | 2601 SCOTT AVE FORT WORTH, TX 76103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | $192 | $320 | 1.49% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DR IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | $46 | $257 | 1.19% |
| KAREN TYLER-DUNN3 | 714 SEYMOUR DR FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $31 | $188 | 0.87% |
| CAROL M PASTERNAK-RIFFE3 | 247 GRAHAM DR FORNEY, TX 75126 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | $20 | $140 | 0.65% |
| EAST TEXAS BUSINESS SOLUTIONS LLC3 | 641 COUNTY RD 2311 MINEOLA, TX 75773 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $26 | $35 | 0.16% |
| ANNETTE BASTON ROBINSON3 | 5401 MANSEL LN FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.08% |
| HAMMAN MILLER BEAUCHAMP DEEBLE3 Filed as: HAMMAN GROUP INSURANCE | — | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $325 | $0 | $325 | 4.78% |
| K HARRIS & ASSOCIATES, LLC3 Filed as: HARRIS BRUCE | — | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $325 | $0 | $325 | 4.78% |
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 | 91 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 91 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 184 | $53K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 184 | $53K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 41 | $7K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 57 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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.