| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM - FORT WORTH, INC. | 1600 WEST 7TH STREET SUITE 100 FORT WORTH, TX 761020000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $59K | — | $59K | 9.70% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH INC. | 1600 WEST SEVENTH STREET FORT WORTH, TX 76102 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $73K | — | $73K | 19.29% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $259 | $259 | 0.07% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM - FORT WORTH, INC. | 1600 WEST 7TH STREET SUITE 100 FORT WORTH, TX 761020000 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 10.03% |
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 | 780 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 797 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 705 | $609K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 1,618 | $78K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 780 | $380K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 780 | $380K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 780 | $380K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 423 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,618 | — |
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.