| 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 | $20K | $2K | $22K | 4.50% |
| KATHY CHURCHILL INS AGENCY INC3 Filed as: KATHY CHURCHILL INSURANCE AGENCY IN | 3303 N MIDKIFF RD MIDLAND, TX 79705 | BLUECROSS BLUESHIELD OF TEXAS | $20K | — | $20K | 4.13% |
| JONES BROS DIRT & PAVING CONTRACTOR3 | 1401 S GRANDVIEW ODESSA, TX 79761 | BLUECROSS BLUESHIELD OF TEXAS | — | $21 | $21 | 0.00% |
| KATHY CHURCHILL INS AGENCY INC3 Filed as: KATHY CHURCHILL INSURANCE AGENCY | 3303 N. MIDKIFF RD. #148 MIDLAND, TX 79705 | BLUECROSS BLUESHIELD OF TEXAS | — | $9 | $9 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 110 MARIENDFIELD STE 330 MIDLAND, TX 79701 | BLUECROSS BLUESHIELD OF TEXAS | — | $9 | $9 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 110 MARIENFIELD STE 330 MIDLAND, TX 79701 | BLUECROSS BLUESHIELD OF TEXAS | — | $9 | $9 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE FLOOR 14 ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $41 | $12K | 10.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.35% |
| RODGERS LINCOLN WELLS3 | 415 W WALL ST SUITE 1818 MIDLAND, TX 79701 | AFLAC | $3K | $19 | $4K | 6.27% |
| AMANDA MCCANN POTTER3 | 911 NORTH MIDKIFF ROAD MIDLAND, TX 79701 | AFLAC | $1K | $13 | $1K | 1.98% |
| KATHY CHURCHILL INS AGENCY INC3 | 3303 NORTH MIDKIFF SUITE 148 MIDLAND, TX 79705 | AFLAC | $942 | — | $942 | 1.69% |
| BENNETT G COOK IV3 | 3812 32ND STREET LUBBOCK, TX 79410 | AFLAC | $907 | $19 | $926 | 1.66% |
| ELVIA L GOMEZ3 | 2905 SAVOY PLACE MIDLAND, TX 79705 | AFLAC | $834 | — | $834 | 1.49% |
| PATRICIA LYNN WIDNER3 Filed as: PATRICIA LYNN WINDNER | 4925 RUSTIC TRAIL MIDLAND, TX 79707 | AFLAC | $814 | — | $814 | 1.46% |
| NANCY B PENA3 | 1535 CAMELLIA LANE NEW BRAUNFELS, TX 78130 | AFLAC | $439 | $19 | $458 | 0.82% |
| SUSAN E RYAN3 | PO BOX 71 CORNELIUS, OR 97113 | AFLAC | $263 | — | $263 | 0.47% |
| STEVE WHITTEN3 | 7606 UNIVERSITY AVENUE SUITE F LUBBOCK, TX 79423 | AFLAC | $241 | — | $241 | 0.43% |
| PETER B WILKINSON JR3 | 6202 IOLA AVENUE SUITE 115 LUBBOCK, TX 79424 | AFLAC | $185 | — | $185 | 0.33% |
| ROSS L WELLS3 | 415 W WALL STREET SUITE 1818 MIDLAND, TX 79701 | AFLAC | $142 | — | $142 | 0.25% |
| BOBBY R STEWART3 | 3501 FRENCH PARK DRIVE SUITE E EDMOND, OK 73034 | AFLAC | $138 | — | $138 | 0.25% |
| ELVIA L GOMEZ3 | 3606 BERMUDA COURT MIDLAND, TX 79707 | AFLAC | $105 | — | $105 | 0.19% |
| CHRISTIE MOSLEY3 Filed as: CHRISTIE ANNE MOSLEY | PO BOX 871 ODESSA, TX 79760 | AFLAC | $77 | $11 | $88 | 0.16% |
| MELINDA ANNE VILLALOBOS3 | 124 NORTH OAK STREET KERMIT, TX 79745 | AFLAC | $52 | $8 | $60 | 0.11% |
| LISA RENEE FREE3 | 204 HERVEY STREET DAINGERFIELD, TX 75638 | AFLAC | $33 | — | $33 | 0.06% |
| N C HALBERT III3 | 4400 N BIG SPRING STREET SUITE E 130 MIDLAND, TX 79705 | AFLAC | $33 | — | $33 | 0.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT L CLARK | 7606 UNIVERSITY AVENUE SUITE F LUBBOCK, TX 79423 | AFLAC | $32 | — | $32 | 0.06% |
| YANET PADILLA GALVAN3 | 1503 SOUTH LEON AVENUE MONAHANS, TX 79756 | AFLAC | $28 | — | $28 | 0.05% |
| DAVID W. KUHLMANN3 Filed as: DAVID W KUHLMANN | 4620 CONLEY AVENUE ODESSA, TX 79762 | AFLAC | $26 | — | $26 | 0.05% |
| CECIL RAY PARKER3 | 1102 FM 378 LORENZO, TX 79343 | AFLAC | $26 | — | $26 | 0.05% |
| KATHY J CHURCHILL3 | 3303 NORTH MIDKIFF ROAD SUITE 148 MIDLAND, TX 79705 | AFLAC | $22 | — | $22 | 0.04% |
| BLESSED MOSLEY INC3 | 4803 PLAZA BOULEVARD SUITE 702 ODESSA, TX 79762 | AFLAC | $15 | $3 | $18 | 0.03% |
| SAMUEL L AUSTIN3 | 4008 CYNTHIA DRIVE MIDLAND, TX 79705 | AFLAC | $17 | — | $17 | 0.03% |
| TERRY B RICH3 | 1605 ENCINO DRIVE LEANDER, TX 78641 | AFLAC | $10 | — | $10 | 0.02% |
| FRANKLIN R DAVIES3 | 201 ROYAL ABERDEEN WAY MCKINNEY, TX 75070 | AFLAC | $10 | — | $10 | 0.02% |
| ROBERT PERRY EVANS JR3 | 1031 SADDLEBROOK DRIVE LUCAS, TX 75002 | AFLAC | $8 | — | $8 | 0.01% |
| STEVE WHITTEN3 | 7606 UNIVERSITY AVENUE SUITE F LUBBOCK, TX 79423 | AFLAC | $7 | — | $7 | 0.01% |
| ROBERT PERRY EVANS JR3 Filed as: ROBERT P EVANS JR INC | 1031 SADDLEBROOK DRIVE LUCAS, TX 75002 | AFLAC | $7 | — | $7 | 0.01% |
| KATY ANN ROWOLDT3 | 10605 EAST COUNTY ROAD 104 MIDLAND, TX 79706 | AFLAC | $2 | — | $2 | 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 | — | $4K | 7.50% |
| 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 | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | — | $591 | $591 | 1.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 110 NORTH MARIENFIELD SUITE 330 MIDLAND, TX 79701 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 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 | — | $374 | $374 | 2.97% |
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 | 272 | 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) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 409 | $120K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 409 | $120K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 272 | $105K |
| Short-term disability | AFLAC | 54 | $56K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TEXAS | 423 | $479K |
| Other(3 contracts, 2 carriers) | AFLAC | 272 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 423 | — |
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.