| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STAMATIS,KRISTOPHER,PAUL3 | 4848 LEMMON AVENUE DALLAS, TX 75219 | AMERITAS LIFE INSURANCE CORP. | $4K | — | $4K | 15.00% |
| KRISTOPHER PAUL STAMATIS3 Filed as: KRISTOPHER STAMATIS | 4848 LEMMON AVENUE STE 805 DALLAS, TX 75219 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $202 | $3K | 20.17% |
| AMARILIS ALTAGRACIA CSIKORTOS3 | 480 CREEK TERRACE DR SAGINAW, TX 76131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $319 | $1K | 8.55% |
| 3B VENTURE GROUP INC3 Filed as: 3B VENTURE GROUP OF TEXAS INC | 832 MALLARD TRL MURPHY, TX 75094 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $423 | $385 | $808 | 5.08% |
| RUBEN D PEREZ3 | 6352 ALCORN AVE DALLAS, TX 75217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $483 | $14 | $497 | 3.12% |
| JGBENEFITS CONSULTANTS3 | 12300 FORD ROAD STE 450 FARMERS BRANCH, TX 75234 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $479 | $0 | $479 | 3.01% |
| PATRICIA HERNANDEZ3 | 4313 AUGUSTA DR GARLAND, TX 75041 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $221 | $0 | $221 | 1.39% |
| CHRISTOPHER D TYLER3 | 714 SEYMOUR DR FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $87 | $185 | 1.16% |
| KAREN TYLER-DUNN3 | 714 SEYMOUR DR FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | $41 | $138 | 0.87% |
| MPART BENEFITS INC3 | 100 ALBRIGHT LN PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $79 | $137 | 0.86% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | 100 ALBRIGHT LANE PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $13 | $22 | 0.14% |
| GAIL MARIE HUMPHREY3 | 3631 GALLAGHER ST DALLAS, TX 75212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSURED BENEFITS ADMINSTRATORS PROVIDER | Other services; Other insurance fees and expenses Service code 49 | 8150 NORTH CENTRAL EXPRESSWAY 1700 DALLAS, TX 75206 | $12K |
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 | 107 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 30 | $16K |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 107 | $43K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 107 | $43K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 30 | $16K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 30 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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.