| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | 801 SOUTH FILLMORE, SUITE 300 AMARILLO, TX 79101 | INTERNATIONAL SPECIALTY UNDERWRITERS INC | $0 | $65K | $65K | 10.92% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | P.O. BOX 1299 AMARILLO, TX 79105 | AMERITAS LIFE INSURANCE CORP. | $26K | $630 | $27K | 10.24% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP, LLC | 18700 N. HAYDEN ROAD, SUITE 405 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY | 801 SOUTH FILLMORE, SUITE 300 AMARILLO, TX 79101 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 7.42% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY | 801 SOUTH FILLMORE, SUITE 300 AMARILLO, TX 79101 | COMPANION LIFE INSURANCE COMPANY | $943 | — | $943 | 7.42% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY | 801 SOUTH FILLMORE, SUITE 300 AMARILLO, TX 79101 | COMPANION LIFE INSURANCE COMPANY | $681 | — | $681 | 7.42% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY | 801 SOUTH FILLMORE, SUITE 300 AMARILLO, TX 79101 | COMPANION LIFE INSURANCE COMPANY | $149 | — | $149 | 7.40% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY | 801 SOUTH FILLMORE, SUITE 300 AMARILLO, TX 79101 | COMPANION LIFE INSURANCE COMPANY | $62 | — | $62 | 7.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INSURANCE MANAGEMENT SERVICES EIN 75-2355889 THIRD PARTY ADMINISTRATOR | Plan Administrator; Claims processing Service code 12 | 731 N. TAYOR ST. AMARILLO, TX 79107 | $116K |
| TELADOC DIRECT EIN 04-3705970 TELAMEDICINE | Other services Service code 49 | 1945 LAKEPOINTE DR. LEWISVILLE, TX 75057 | $19K |
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 | 338 | 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) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INTERNATIONAL SPECIALTY UNDERWRITERS INC | 338 | $596K |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 719 | $278K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 719 | $261K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 395 | $15K |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 364 | $9K |
| Long-term disability | COMPANION LIFE INSURANCE COMPANY | 18 | $838 |
| Prescription drug | INTERNATIONAL SPECIALTY UNDERWRITERS INC | 338 | $596K |
| Other(4 contracts, 3 carriers) | AMERITAS LIFE INSURANCE CORP. | 719 | $322K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 719 | — |
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.