| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CYNTHIA PRINCE3 Filed as: CYNTHIA Z PRINCE | 200 PALO PINTO WEATHERFORD, TX 76086 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 11.77% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE ROOM 606 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $222 | $222 | 0.75% |
| CYNTHIA PRINCE3 Filed as: CYNTHIA Z PRINCE | 200 PALO PINTO WEATHERFORD, TX 76086 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 14.31% |
| NYLIFE SECURITIES LLC3 Filed as: NYLIFE SECURITIES | 51 MADISON AVE ROOM 606 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $131 | $131 | 0.75% |
| KELLY S. MADDEN3 Filed as: KELLY S MADDEN | 5714 YORK AVE LUBBOCK, TN 79414 | AFLAC | $2K | $24 | $2K | 12.96% |
| MJ INSURANCE3 Filed as: CARRIE DAWN BLAIR | 4502 80TH ST LUBBOCK, TX 79424 | AFLAC | $404 | $14 | $418 | 2.41% |
| L CARTHEL ENTERPRISE INC3 | 4409 71ST STREET LUBBOCK, TX 79424 | AFLAC | $376 | $14 | $390 | 2.25% |
| KELSEY SHAWN MADDEN3 | 5714 YORK AVE LUBBOCK, TN 79414 | AFLAC | $140 | — | $140 | 0.81% |
| STEVE WHITTEN3 | 7606 UNIVERSITY AVE STE F LUBBOCK, TX 79423 | AFLAC | $120 | $14 | $134 | 0.77% |
| ANGELIQUE N LILES3 | 305 REGENCY PKWY STE 605 MANSFIELD, TX 76063 | AFLAC | $91 | — | $91 | 0.52% |
| MILTON M KLEINBERG3 | 8420W DODGE RD #510 OMAHA, NE 68114 | AFLAC | $91 | — | $91 | 0.52% |
| DORINDA J COOPER3 | 8302 ALBANY AVE LUBBOCK, TX 79424 | AFLAC | $58 | $28 | $86 | 0.50% |
| L & D JACKSON ENTERPRISES INC3 Filed as: L&D JACKSON ENTERPRISES INC | 121 FLYNT RD HUNTSVILLE, TN 77320 | AFLAC | $75 | — | $75 | 0.43% |
| ANDY HINES3 | PO BOX 53265 LUBBOCK, TX 79453 | AFLAC | $44 | — | $44 | 0.25% |
| DAVID L DEARDORFF3 Filed as: DAVID DEARDORFF | 9083 E 138TH S BIXBY, OK 74008 | AFLAC | $43 | — | $43 | 0.25% |
| FRANKLIN R DAVIES3 | 201 ROYAL ABERDEEN WAY MCKINNEY, TX 75070 | AFLAC | $40 | — | $40 | 0.23% |
| DAVID L KLEVAN3 | DBA CBMG 5100 POPLAR AVE STE 2755 MEMPHIS, TN 38137 | AFLAC | $18 | — | $18 | 0.10% |
| RONALD LARRY HANKINS3 | 515 YAUPON DR GARLAND, TX 75044 | AFLAC | $6 | — | $6 | 0.03% |
| HAL W WESLEY JR3 | 10000 SAN LEON DR. DICKINSON, TX 77539 | AFLAC | $5 | — | $5 | 0.03% |
| DARIN GREENE3 | 2111 MAIN ST PETERSBURG, TX 79250 | AFLAC | $4 | — | $4 | 0.02% |
| MICHAEL GRASS3 | 25618 RYANS CREEK CT KATY, TX 77494 | AFLAC | $3 | — | $3 | 0.02% |
| CYNTHIA PRINCE3 | 200 PALO PINTO WEATHERFORD, TX 76086 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.75% |
| NYLIFE SECURITIES LLC3 Filed as: NYLIFE SECURITIES LL | 51 MADISON AVE ROOM 606 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $77 | $77 | 0.79% |
| CYNTHIA PRINCE3 Filed as: CYNTHIA Z PRINCE | 200 PALO PINTO WEATHERFORD, TX 76086 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $785 | — | $785 | 15.00% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $39 | $39 | 0.74% |
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 | 204 | 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) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability(4 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $62K |
| Other | AFLAC | 35 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.