| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | — | BLUECROSS BLUESHIELD OF TEXAS | $76K | $1K | $77K | 3.94% |
| ASSUREDPARTNERS3 | 500 CENTRAL EXPRESSWAY, SUITE 550 PLANO, TX 75074 | SUNLIFE ASSURANCE COMPANY OF CANADA | $18K | — | $18K | 11.46% |
| ASSUREDPARTNERS3 | 500 NORTH CENTRAL EXPRESSWAY SUITE 550 PLANO, TX 75074 | RELIANCE MATRIX | $8K | $0 | $8K | 10.00% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | RELIANCE MATRIX | $0 | $180 | $180 | 0.22% |
| ASSUREDPARTNERS3 | UNKNOWN DALLAS, TX 75214 | ESI EMPLOYEE ASSISTANCE GROUP | $388 | $0 | $388 | 5.00% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 241 | $2.0M |
| Dental | SUNLIFE ASSURANCE COMPANY OF CANADA | 142 | $153K |
| Vision | SUNLIFE ASSURANCE COMPANY OF CANADA | 142 | $153K |
| Life insurance | RELIANCE MATRIX | 143 | $81K |
| Short-term disability | RELIANCE MATRIX | 143 | $81K |
| Long-term disability | RELIANCE MATRIX | 143 | $81K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 241 | $2.0M |
| Other(3 contracts, 3 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 311 | $242K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.