| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN L. WORTHAM & SON, LP | PO BOX 301598 DALLAS, TX 75303 | EYEMED VISION CARE | $36 | — | $36 | 4.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUESHIELD EIN 23-1294723 NONE | Other fees; Direct payment from the plan; Claims processing Service code 12 | — | $472K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 41-1289245 NONE | Other services; Direct payment from the plan; Claims processing Service code 12 | — | $147K |
| ERNST & YOUNG LLP EIN 34-6565596 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $113K |
| FIDELITY INVESTMENT INSTITUTIONAL EIN 04-2647786 NONE | Direct payment from the plan; Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $29K |
| WELLS FARGO EIN 94-1347393 NONE | Distribution (12b-1) fees; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Investment management; Trustee (directed); Investment management fees paid indirectly by plan Service code 21 | — | $9K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 875 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 875 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 11 | $770 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.