| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY | — | UNITED HEALTHCARE INSURANCE COMPANY | $194K | — | $194K | 9.97% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL | ACIUS CONSULTING GROUP 2591 DALLAS PARKWAY STE. 203 FRISCO, TX 75034 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $46K | — | $46K | 2.43% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL | ACIUS CONSULTING GROUP 2591 DALLAS PARKWAY STE 203 FRISCO, TX 75034 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $46K | — | $46K | 9.64% |
| HOLMES MURPHY & ASSOCIATES3 | 12712 PARK CENTRAL DR. STE 100 DALLAS, TX 752511527 | VISION SERVICE PLAN | $14K | — | $14K | 5.00% |
| HOLMES MURPHY & ASSOCIATES3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 7.49% |
| HOLMES MURPHY & ASSOCIATES3 | P.O. BOX 9207 DES MOINES, IA 503069207 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE C | $7K | — | $7K | 4.97% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL | ACIUS CONSULTING GROUP 2591 DALLAS PARKWAY, STE 203 FRISCO, TX 75034 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | — | $0 | 0.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY ASSOC. | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $1.9M |
| CVS HEALTH EIN 05-0340626 THIRD PARTY ADMINISTRATOR | Other services; Claims processing Service code 12 | — | $232K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Claims processing; Other services Service code 12 | — | $199K |
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $89K |
| LIBERTY LIFE ASSURANCE COMPANY OF B EIN 75-2109502 THIRD PARTY ADMINISTRATOR | Claims processing; Other services Service code 12 | — | $46K |
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 | 3,784 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 3,784 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRIPLE S SALUD, INC | 14 | $7.7M |
| Dental(3 contracts, 3 carriers) | TRIPLE S SALUD, INC | 845 | $7.9M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,561 | $333K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 3,386 | $1.9M |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 845 | $388K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,774 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.