| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1301 DOVE STREET SUITE 200 NEWPORT BEACH, CA 92660 | BLUE CROSS BLUE SHIELD OF TEXAS | $40K | $0 | $40K | 2.77% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1301 DOVE STREET SUITE 200 NEWPORT BEACH, CA 92660 | DEARBORN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 13.65% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $20 | $4K | 15.09% |
| GENWIL BENEFITS GROUP LLC3 | 2163 W VILLAGE DR PHOENIX, AZ 85023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $188 | $2K | 7.75% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $573 | $656 | $1K | 4.57% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM RALPH DECKER | 2163 W VILLAGE DR PHOENIX, AZ 85023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $399 | $70 | $469 | 1.74% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $307 | $30 | $337 | 1.25% |
| SHAUNA M SORIA3 | 5630 S ASHLEY DR CHANDLER, AZ 85249 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $276 | $32 | $308 | 1.15% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $50 | $67 | 0.25% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $23 | $36 | 0.13% |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 303 | $1.4M |
| Dental | BLUE CROSS BLUE SHIELD OF TEXAS | 303 | $1.4M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 262 | $40K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 262 | $40K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 262 | $40K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 262 | $40K |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 262 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.