| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANBTX INSURANCE SERVICES, INC.3 Filed as: ANBTX INSURANCE SERVICES INC. | 12400 COIT ROAD STE 100 DALLAS, TX 752512039 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 7.84% |
| DMS INSURANCE AGENCY OF TEXAS LLC Filed as: DMS INSURANCE AGENCY OF TEXAS | 12400 COIT ROAD STE 100 DALLAS, TX 75251 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $356 | — | $356 | 6.71% |
| DMS INSURANCE AGENCY OF TEXAS LLC Filed as: DMS INSURANCE AGENCY OF TEXAS | 12400 COIT ROAD STE 100 DALLAS, TX 75251 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $298 | — | $298 | 5.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIM ADMINISTRATOR | Float revenue; Named fiduciary; Claims processing; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $3K |
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 | 124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $28K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $5K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $5K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $5K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $5K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.