| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY INC | P O BOX 1299 AMARILLO, TX 791051299 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $17K | $17K | 4.54% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY, INC | PO BOX 1299 AMARILLO, TX 791050299 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $2K | $9K | 12.50% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY, INC | PO BOX 1299 AMARILLO, TX 791050299 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 23.27% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY, INC | PO BOX 1299 AMARILLO, TX 791050299 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 23.50% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY, INC | PO BOX 1299 AMARILLO, TX 791050299 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 11.65% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY, INC | PO BOX 1299 AMARILLO, TX 79105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $888 | $2K | 26.12% |
| UPSHAW INSURANCE AGENCY INC.3 Filed as: UPSHAW INSURANCE AGENCY, INC | PO BOX 1299 AMARILLO, TX 791050299 | SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION | $172 | $43 | $215 | 12.52% |
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 | 62 | 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) | 62 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 54 | $374K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 141 | $74K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 141 | $72K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 41 | $24K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 36 | $24K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 6 | $8K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.