| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANCO INS. SVC. OF BRYAN COLLEGE STA3 Filed as: ANCO INSURANCE SERVICES CORPORATION | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48K | $6K | $54K | 11.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | COMPBENEFITS | $29K | — | $29K | 10.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 218060 HOUSTON, TX 77218 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 12.68% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $3K | $11K | 12.34% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 6.21% |
| KATHERINE ANN KELLY3 | 3505 SAGE ROAD HOUSTON, TX 77056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $535 | $3K | 3.15% |
| MJ INSURANCE3 Filed as: PARISH PEACHEE AND VARIOUS AGENTS | 201 WEST 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $971 | $3K | 3.04% |
| TIMOTHY J REED3 Filed as: TIMOTHY J. REED | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $325 | $1K | 1.52% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA, UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $995 | $165 | $1K | 1.32% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $454 | $1 | $455 | 9.06% |
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 | 356 | 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) | 356 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPBENEFITS | 291 | $272K |
| Vision | COMPBENEFITS | 291 | $272K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 356 | $453K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 356 | $453K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 356 | $453K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 356 | $546K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 356 | — |
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.