| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID S LEISS3 Filed as: DAVID S. LEISS | 11506 BURGOYNE DRIVE, STE. 300 HOUSTON, TX 77077 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 10.10% |
| PLUMHOFF AND ASSOCIATES, INC.3 Filed as: PLUMHOFF & ASSOCIATES INC | PO BOX 218060 HOUSTON, TX 77218 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $7K | 18.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 840 GESSNER RD # 600 HOUSTON, TX 77024 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $857 | $8K | 27.90% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $754 | $182 | $936 | 5.35% |
| DAVID S LEISS3 Filed as: DAVID S. LEISS | 11506 BURGOYNE DRIVE, STE. 300 HOUSTON, TX 77077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $665 | — | $665 | 3.80% |
| WAYNE JAMES PITRIE3 | 9737 BEVLYN DRIVE HOUSTON, TX 77025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $298 | $26 | $324 | 1.85% |
| SHARON LEA HART3 | PO BOX 1872 HILLTOP LAKES, TX 77871 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | — | $179 | 1.02% |
| KATHERINE ANN KELLY3 | 3505 SAGE ROAD HOUSTON, TX 77056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $31 | $158 | 0.90% |
| LYNDA TANNER3 | PO BOX 1225 SEABROOK, TX 77586 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 0.45% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $11 | $49 | 0.28% |
| NATALIE JONES TELTOW3 | 1742 WICKHAM REACH DRIVE SPRING, TX 77386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.22% |
| SUSAN SIDELL3 | 931 WEST 42ND STREET HOUSTON, TX 77018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.11% |
| DONALD GRANT JAMES3 | 2706 TAMPA STREET FRIENDSWOOD, TX 77546 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $6 | $10 | 0.06% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC. | 500 WEST 13TH STREET FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.04% |
| PARISH J PEACHEE3 | 201 WEST 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.03% |
| SA GENERAL AGENCY INC3 | 9385 MILLER LANE GARDEN RIDGE, TX 78266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| FROST INSURANCE AGENCY INC3 | 5555 SAN FELIPE, STE 850 HOUSTON, TX 77056 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 13.10% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $461 | $126 | $587 | 6.55% |
| DAVID S LEISS3 Filed as: DAVID S. LEISS | 11506 BURGOYNE DRIVE, STE. 300 HOUSTON, TX 77077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $375 | — | $375 | 4.18% |
| WAYNE JAMES PITRIE3 | 9737 BEVLYN DRIVE HOUSTON, TX 77025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | $18 | $229 | 2.55% |
| KATHERINE ANN KELLY3 | 3505 SAGE ROAD HOUSTON, TN 77056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | $21 | $104 | 1.16% |
| NATALIE JONES TELTOW3 | 1742 WICKHAM REACH DRIVE SPRING, TX 77386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $6 | $67 | 0.75% |
| SHARON LEA HART3 | PO BOX 1872 HILLTOP LAKES, TX 77871 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.56% |
| LYNDA TANNER3 | PO BOX 1225 SEABROOK, TX 77586 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.29% |
| COORDINATED BENEFIT ADVISORS3 | 13750 CROSSTOWN DR NW ANDOVER, MI 55304 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.26% |
| SUSAN SIDELL3 | 931 WEST 42ND STREET HOUSTON, TX 77018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.07% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC. | 500 WEST 13TH STREET FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.06% |
| SA GENERAL AGENCY INC3 | 9385 MILLER LANE GARDEN RIDGE, TX 78266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
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 | 270 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $90K |
| Life insurance(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 229 | $92K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $90K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.