| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONNA S POLSER3 Filed as: DONNA S. POLSER | 1210 COUNTY ROAD 4930 LEONARD, TX 75452 | AFLAC | $16K | $2K | $17K | 16.01% |
| MJ INSURANCE3 Filed as: JADE E. CHAVEZ AND VARIOUS AGENTS | 110 NORTH INTERSTATE 35, SUITE 315 ROUND ROCK, TX 75023 | AFLAC | $4K | $175 | $4K | 4.03% |
| JOHN DEE MAULDIN3 | 3209 PHAETON COURT PLANO, TX 75023 | AFLAC | $2K | $327 | $3K | 2.49% |
| AMBER DOTTS3 | 3402 ENTERPRISE DRIVE ROWLETT, TX 75088 | AFLAC | $2K | $321 | $2K | 2.28% |
| CANDICE RENEE TREVINO3 | 12594 SOUTH STATE HIGHWAY, SUITE 12 TRENTON, TX 75490 | AFLAC | $2K | $6 | $2K | 1.56% |
| ROBERT PERRY EVANS JR3 Filed as: ROBERT PERRY EVANS JR. | 1031 SADDLEBROOK DRIVE LUCAS, TX 75002 | AFLAC | $1K | $325 | $2K | 1.51% |
| DONNA DAVIS3 | 9543 ESTONE CIRCLE SPRING, TX 77379 | AFLAC | $731 | $28 | $759 | 0.70% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.90% |
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 | 514 | 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) | 514 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AFLAC | 514 | $117K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 794 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 514 | $79K |
| Short-term disability | AFLAC | 182 | $109K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 514 | $79K |
| Prescription drug | TELADOC | 514 | $8K |
| Other(2 contracts, 2 carriers) | AFLAC | 514 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 794 | — |
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.