| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ARK ASSURANCE GROUP INC | 212 GRANDE BLVD SUITE A 214 TYLER, TX 75713 | INTERNATIONAL SPECIALTY UNDERWRITERS/COMPANION LIFE INSURANCE | $49K | $0 | $49K | 15.00% |
| ASSURANCE AGENCY LTD3 Filed as: ARK ASSURANCE GROUP INC. | 212 GRANDE BLVD #A214 TYLER, TX 75703 | SUPERIOR VISION PLAN | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | P.O. BOX 1087 WAUSAU, WI 54402 | $390K |
| HEALTHFIRST TPA, INC EIN 75-2348381 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | P.O. BOX 130217 821 ESE LOOP 323 SUITE 200 TYLER, TX 75701 | $131K |
| ACCESS DIRECT EIN 75-2850142 INSURANCE SERVICES | Insurance services Service code 23 | P.O. BOX 130549 TYLER, TX 75713 | $44K |
| MM SOLUTIONS EIN 75-2850143 INSURANCE SERVICES | Insurance services Service code 23 | P.O. BOX 6307 TYLER, TX 75285 | $10K |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE/MEI | 305 | $59K |
| Vision | SUPERIOR VISION PLAN | 227 | $36K |
| Stop-loss / reinsurancereinsurance | INTERNATIONAL SPECIALTY UNDERWRITERS/COMPANION LIFE INSURANCE | 305 | $329K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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.