| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBC BENEFITS LTD3 | 2409 FOREST PARK BLVD. 2ND FLOOR FORT WORTH, TX 76110 | CIGNA | $24 | $0 | $24 | 0.01% |
| GUS BATES INSURANCE3 | 2409 FOREST PARK BLVD. STE 102 FORT WORTH, TX 76110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $0 | $12K | 14.94% |
| GBC BENEFITS LTD3 | 2409 FOREST PK BLVD FT. WORTH, TX 76110 | THE STANDARD | $17K | $0 | $17K | 41.17% |
| GBC BENEFITS LTD3 Filed as: GBC BENEFITS, LTD | 2409 FOREST PARK BLVD FL 2 FORT WORTH, TX 76110 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.49% |
| PHILLIP M. ERNEST & ASSOCIATES, INC4 Filed as: PHILLIP M. ERNEST & ASSOC. INC. | 3125 MARQUITA DR FORT WORTH, TX 76116 | PRE-PAID LEGAL SERVICES, INC. | $2K | $0 | $2K | — |
| REP TELEMARKETING SERVICES INC4 Filed as: REP TELEMARKETING SERVICES, INC. | 11762 SKYLARK CT AUBURN, CA 95602 | PRE-PAID LEGAL SERVICES, INC. | $871 | $0 | $871 | — |
| ARISON ENTERPRISE LLP4 | 509 S 1ST ST ATWOOD, KS 67730 | PRE-PAID LEGAL SERVICES, INC. | $424 | $0 | $424 | — |
| ARISON ENTERPRISE LLP4 Filed as: ARISON ENTRPRISES LLP | 509 S 1ST ST ATWOOD, KS 67730 | PRE-PAID LEGAL SERVICES, INC. | $424 | $0 | $424 | — |
| J KEEBS & ASSOCIATES4 | 1950 BUFORD DAM ROAD APT. 406 CUMMING, GA 30041 | PRE-PAID LEGAL SERVICES, INC. | $124 | $0 | $124 | — |
| GROUP BENEFITS LTD4 Filed as: GROUP AGENCY | PO BOX 113 VINTON, VA 24179 | PRE-PAID LEGAL SERVICES, INC. | $119 | $0 | $119 | — |
| DONNA S. KRAMER4 | 875 TAMALPAIS AVE APT 11 NOVATO, CA 94947 | PRE-PAID LEGAL SERVICES, INC. | $90 | $0 | $90 | — |
| AGAR THOMAS4 | 524 LEE ST BURLINGTON, NC 27217 | PRE-PAID LEGAL SERVICES, INC. | $42 | $0 | $42 | — |
| JAMES LENCIONI4 | 1118 DOYLE ST BAKERSFIELD, CA 93308 | PRE-PAID LEGAL SERVICES, INC. | $35 | $0 | $35 | — |
| BRAD COLOVICH & ASSOC INC4 Filed as: BRAD COLOVICH & ASSOC | 115 N CENTER ST MIDWAY, UT 84049 | PRE-PAID LEGAL SERVICES, INC. | $33 | $0 | $33 | — |
| ROBBIN A MARTINELLLI4 Filed as: ROBBIN MARTINELLI | 11 CAMBRIDGE CT. HARDY, CT 24101 | PRE-PAID LEGAL SERVICES, INC. | $33 | $0 | $33 | — |
| BLUMCIA BUSINESS SOLUTIONS4 | 3440 YOUNGFIELD ST WHEAT RIDGE, CO 80033 | PRE-PAID LEGAL SERVICES, INC. | $31 | $0 | $31 | — |
| JOAN POLZIN4 | 441 W 14TH AVE SPOKANE, WA 99204 | PRE-PAID LEGAL SERVICES, INC. | $27 | $0 | $27 | — |
| KCA MARKETING INC DBA LEGAL BENEFIT4 | P.O. BOX 1833 SAINT CLOUD, MN 56302 | PRE-PAID LEGAL SERVICES, INC. | $19 | $0 | $19 | — |
| RONALD CHAMBERS4 | 3281 PLATEAU PL CINCINNATI, OH 45241 | PRE-PAID LEGAL SERVICES, INC. | $8 | $0 | $8 | — |
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 | 452 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 729 | $423K |
| Dental | CIGNA | 729 | $423K |
| Vision | VISION SERVICE PLAN | 364 | $33K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 539 | $126K |
| Short-term disability | THE STANDARD | 539 | $42K |
| Long-term disability | THE STANDARD | 539 | $42K |
| Stop-loss / reinsurancereinsurance | CIGNA | 729 | $423K |
| Other(2 contracts, 2 carriers) | WORKERS ASSISTANCE PROGRAM, INC. | 550 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 729 | — |
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.