| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SANFORD AND TATUM3 | 5241 98TH STREET LUBBOCK, TX 79424 | TRANSAMERICA | $20K | — | $20K | 10.00% |
| CAPROCK HEALTHPLANS5 | 4401 82ND LUBBOCK, TX 79424 | TRANSAMERICA | $10K | — | $10K | 5.00% |
| CAPROCK HEALTHPLANS5 Filed as: CAPROCK HEALTHPLANS INC. | 4401 82ND STE 1200 LUBBOCK, TX 79424 | OPTUM | $1K | — | $1K | 5.32% |
| SANFORD AND TATUM3 | 5241 98TH STREET LUBBOCK, TX 79424 | OPTUM | $1K | — | $1K | 4.62% |
| CAPROCK HEALTHPLANS5 | 4401 82ND STE 1200 LUBBOCK, TX 79424 | PRUDENTIAL | $788 | — | $788 | 7.94% |
| SANFORD AND TATUM3 | 5241 98TH STREET LUBBOCK, TX 79424 | PRUDENTIAL | $743 | — | $743 | 7.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPROCK HEALTHPLANS EIN 75-2878837 CONTRACT ADMINSTRATOR | Contract Administrator Service code 13 | — | $149K |
| GLASS CONTROL, INC. EIN 75-2203190 EMPLOYER SPONSOR | Contract Administrator Service code 13 | — | $36K |
| BOLINGER,SEGARS,GILBERT & MOSS EIN 75-0882037 AUDITOR | Accounting (including auditing) Service code 10 | — | $9K |
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 | 232 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL | 234 | $10K |
| Stop-loss / reinsurancereinsurance | TRANSAMERICA | 234 | $197K |
| Other | OPTUM | 234 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.