| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: BOWEN MICLETTE & BRITT INSURANCE | 1111 NORTH LOOP W STE 400 HOUSTON, TX 77008 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $1K | $30K | 14.74% |
| LOCKTON COMPANIES, LLC3 Filed as: BOWEN MICLETTE & BRITT INSURANCE | 1111 NORTH LOOP W STE 400 HOUSTON, TX 77008 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $3K | $158 | $3K | 12.76% |
| LOCKTON COMPANIES, LLC3 Filed as: BOWEN MICLETTE & BRITT INSURANCE | 1111 NORTH LOOP W STE 400 HOUSTON, TX 77008 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $202 | $11 | $213 | 12.67% |
| LOCKTON COMPANIES, LLC3 Filed as: BOWEN MICLETTE & BRITT INSURANCE | 1111 NORTH LOOP W STE 400 HOUSTON, TX 77008 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $54 | $3 | $57 | 13.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS EIN 73-0985223 TPA | Claims processing Service code 12 | 15305 N DALLAS PKWY #100 ADDISON, TX 75001 | $86K |
| BOWEN MICLETTE & BRITT INSURANCE EIN 26-3860108 BROKER | Insurance agents and brokers Service code 22 | 1111 NORTH LOOP W STE 400 HOUSTON, TX 77008 | $76K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 INSURANCE COMPANY | Insurance services Service code 23 | 151 FARMINGTON AVENUE RW61 HARTFORD, CT 06156 | $52K |
| HSCM EIN 36-4099199 TPA | Claims processing Service code 12 | 15305 N DALLAS PKWY #100 ADDISON, TX 75001 | $7K |
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 | 264 | 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) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 789 | $228K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 789 | $202K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 789 | $202K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 789 | $202K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 789 | $202K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 264 | $476K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 789 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 789 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.