| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 110 N MARIENFIELD ST STE 330 MIDLAND, TX 70701 | BLUECROSS BLUESHIELD OF TEXAS | $19K | $1K | $21K | 5.01% |
| KATHY CHURCHILL INS AGENCY INC3 Filed as: KATHY CHURCHILL INSURANCE AGENCY IN | 3303 N MIDKIFF RD MIDLAND, TX 79705 | BLUECROSS BLUESHIELD OF TEXAS | $19K | — | $19K | 4.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE FLOOR 14 ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $1K | $11K | 11.09% |
| RODGERS LINCOLN WELLS3 | 415 W WALL ST SUITE 1818 MIDLAND, TX 79701 | AFLAC | $3K | $115 | $3K | 4.87% |
| KATHY CHURCHILL INS AGENCY INC3 | 3303 NORTH MIDKIFF SUITE 148 MIDLAND, TX 79705 | AFLAC | $2K | — | $2K | 2.33% |
| AMANDA MCCANN POTTER3 | 911 NORTH MIDKIFF ROAD MIDLAND, TX 79701 | AFLAC | $1K | $30 | $1K | 1.59% |
| NANCY B PENA3 | 1717 ATLANTA STREET MIDLAND, TX 79701 | AFLAC | $895 | — | $895 | 1.37% |
| PETER B WILKINSON JR3 | 6202 IOLA AVENUE SUITE 115 LUBBOCK, TX 79424 | AFLAC | $356 | — | $356 | 0.54% |
| SUSAN E RYAN3 | PO BOX 71 CORNELIUS, OR 97113 | AFLAC | $352 | — | $352 | 0.54% |
| STEVE WHITTEN3 | 7606 UNIVERSITY AVENUE SUITE F LUBBOCK, TX 79423 | AFLAC | $336 | — | $336 | 0.51% |
| BENNETT G COOK IV3 | 3812 32ND STREET LUBBOCK, TX 79410 | AFLAC | $323 | — | $323 | 0.49% |
| ROSS L WELLS3 | 415 W WALL STREET SUITE 1818 MIDLAND, TX 79701 | AFLAC | $215 | $23 | $238 | 0.36% |
| BOBBY R STEWART3 | 3501 FRENCH PARK DRIVE SUITE E EDMOND, OK 73034 | AFLAC | $197 | — | $197 | 0.30% |
| NANCY B PENA3 | 1535 CAMELLIA LANE NEW BRAUNFELS, TX 78130 | AFLAC | $166 | — | $166 | 0.25% |
| TERRY B RICH3 | 1605 ENCINO DRIVE LEANDER, TX 78641 | AFLAC | $114 | — | $114 | 0.17% |
| LISA RENEE FREE3 | 204 HERVEY STREET DAINGERFIELD, TX 75638 | AFLAC | $78 | — | $78 | 0.12% |
| STEVE WHITTEN3 | 7606 UNIVERSITY AVENUE SUITE F LUBBOCK, TX 79423 | AFLAC | $37 | $30 | $67 | 0.10% |
| N C HALBERT III3 | 4400 N BIG SPRING STREET SUITE E 130 MIDLAND, TX 79705 | AFLAC | $44 | — | $44 | 0.07% |
| SAMUEL L AUSTIN3 | 4008 CYNTHIA DRIVE MIDLAND, TX 79705 | AFLAC | $39 | — | $39 | 0.06% |
| KATHY J CHURCHILL3 | 3303 NORTH MIDKIFF ROAD SUITE 148 MIDLAND, TX 79705 | AFLAC | $37 | — | $37 | 0.06% |
| DAVID W. KUHLMANN3 Filed as: DAVID W KUHLMANN | 4620 CONLEY AVENUE ODESSA, TX 79762 | AFLAC | $31 | — | $31 | 0.05% |
| MICHAEL ROBERT LLOYD3 | 3229 CIMMARON AVENUE MIDLAND, TX 79705 | AFLAC | $28 | — | $28 | 0.04% |
| ROBERT PERRY EVANS JR3 | 1031 SADDLEBROOK DRIVE LUCAS, TX 75002 | AFLAC | $20 | — | $20 | 0.03% |
| FRANKLIN R DAVIES3 | 201 ROYAL ABERDEEN WAY MCKINNEY, TX 75070 | AFLAC | $19 | — | $19 | 0.03% |
| ROBERT PERRY EVANS JR3 Filed as: ROBERT P EVANS JR INC | 1031 SADDLEBROOK DRIVE LUCAS, TX 75002 | AFLAC | $11 | — | $11 | 0.02% |
| KATY ANN ROWOLDT3 | 10605 EAST COUNTY ROAD 104 MIDLAND, TX 79706 | AFLAC | $5 | — | $5 | 0.01% |
| CHRISTIE MOSLEY3 Filed as: CHRISTIE ANNE MOSLEY | 10548 WEST JOAN DRIVE ODESSA, TX 79764 | AFLAC | $1 | — | $1 | 0.00% |
| MELINDA ANNE VILLALOBOS3 | 808 TOWER DRIVE SUITE 6 ODESSA, TX 79761 | AFLAC | $1 | — | $1 | 0.00% |
| BLESSED MOSLEY INC3 | 4803 PLAZA BOULEVARD SUITE 702 ODESSA, TX 79762 | AFLAC | $0 | — | $0 | 0.00% |
| JOHN WILIAM RIDGWAY3 | PO BOX 9759 MIDLAND, TX 79708 | AFLAC | $0 | — | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 110 NORTH MARIENFIELD SUITE 330 MIDLAND, TX 79701 | HARTFORD LIFE AND ACCIDENT | $4K | $116 | $4K | 7.73% |
| KATHY CHURCHILL INS AGENCY INC3 | 3303 NORTH MIDKIPP ROAD SUITE 148 MIDLAND, TX 79705 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 7.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 110 NORTH MARIENFIELD SUITE 330 MIDLAND, TX 79701 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | — | $32 | $32 | 0.33% |
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 | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 390 | $98K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 390 | $98K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 236 | $116K |
| Short-term disability | AFLAC | 67 | $65K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TEXAS | 380 | $412K |
| Other(3 contracts, 2 carriers) | AFLAC | 236 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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.