| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: INSGROUP, LLC | 2255 RIDGE ROAD SUITE 333 ROCKWALL, TX 75087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILITATES (CIGNA) | $18K | $0 | $18K | 9.87% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | PO BOX 948 HENRIETTA, NY 14468 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $0 | $9K | 13.81% |
| K&S INSURANCE AGENCY3 | 2255 RIDGE ROAD SUITE 333 ROCKWALL, TX 75087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $819 | $0 | $819 | 1.19% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | PO BOX 948 HENRIETTA, NY 14468 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 13.18% |
| K&S INSURANCE AGENCY3 Filed as: K & S INSURANCE AGENCY | 2255 RIDGE ROAD SUITE 333 ROCKWALL, TX 75087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 9.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 7.53% |
| INSGROUP INC3 Filed as: INSGROUP LLC DBA K&S INSURANCE | 5151 SAN FELIPE STE 2400 HOUSTON, TX 77056 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 9.54% |
| K&S INSURANCE AGENCY3 | 2255 RIDGE RD STE 333 ROCKWALL, TX 75087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 9.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 8.32% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | PO BOX 948 HENRIETTA, NY 14468 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 5.23% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | PO BOX 948 HENRIETTA, NY 14468 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 13.22% |
| K&S INSURANCE AGENCY3 Filed as: K & S INSURANCE AGENCY | 2255 RIDGE ROAD SUITE 333 ROCKWALL, TX 75087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $239 | $0 | $239 | 1.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CRUM & FORSTER ADMIN | Plan Administrator Service code 14 | 305 MADISON AVENUE MORRISTOWN, NJ 07960 | $1.1M |
| K&S INSURANCE AGENCY AGENT | Insurance agents and brokers Service code 22 | PO BOX 277 ROCKWALL, TX 75087 | $151K |
| BEVCAP MANAGEMENT, LLC EIN 26-1870141 AGENT | Insurance agents and brokers Service code 22 | — | $106K |
| BOON CHAPMAN - LTD EIN 74-2305238 ADMIN | Claims processing; Plan Administrator Service code 12 | — | $83K |
| AETNA - PPO EIN 06-6033492 ADMIN | Insurance services Service code 23 | — | $64K |
| BEVCAP HEALTH CAPTIVE - NC EIN 26-1870141 ADMIN | Plan Administrator Service code 14 | — | $22K |
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 | 911 | 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) | 911 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILITATES (CIGNA) | 439 | $185K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 265 | $32K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 911 | $61K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $69K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 44 | $24K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INSURANCE COMPANY | 370 | $4K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 460 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 911 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.