| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES REYNOLDS3 Filed as: JAMES D HUBBARD | 800 GESSNER ROAD, STE 300 HOUSTON, TX 77024 | BLUE CROSS & BLUE SHIELD OF TENNESSEE | $88K | $6K | $94K | 1.15% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $52K | $0 | $52K | 10.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $47K | $0 | $47K | 10.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 2.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $0 | $15K | 10.00% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN, INC. | 101 S GARLAND AVE, STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $216 | $0 | $216 | 0.46% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN, INC. | 101 S GARLAND AVE, STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $163 | $0 | $163 | 0.51% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN, INC. | 101 S GARLAND AVE, STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $149 | $0 | $149 | 0.51% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | METROPOLITAN GENERAL INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 10.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | $0 | $1K | 8.76% |
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 | 1,368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,378 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF TENNESSEE | 1,098 | $8.1M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF TENNESSEE | 1,098 | $8.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $149K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $468K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $525K |
| Other(6 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 382 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,098 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.