| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 761010908 | AETNA LIFE INSURANCE CO. | $18K | $0 | $18K | 0.84% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $14K | $4K | $18K | 19.05% |
| FMLASOURCE INC3 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 8.50% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $13K | $4K | $17K | 19.08% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $7K | 19.83% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.22% |
| HEALTHJOY, LLC3 | PO BOX 776932 CHICAGO, IL 60677 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 15.17% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.03% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $4K | $974 | $5K | 24.34% |
| KEITH-AARON BENNETT3 | 105 PLATEAU DR EAST STROUDSBURG, PA 18301 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 22.31% |
| HEALTHJOY, LLC3 | PO BOX 776932 CHICAGO, IL 60677 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 25.47% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY | PO BOX 908 FORT WORTH, TX 76101 | UNTIED OF OMAHA LIFE INSURANCE COMPANY | $3K | $825 | $4K | 19.20% |
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 | 694 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 698 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 443 | $2.1M |
| Dental | AETNA LIFE INSURANCE CO. | 443 | $2.1M |
| Vision | AETNA LIFE INSURANCE CO. | 443 | $2.1M |
| Life insurance(2 contracts) | UNTIED OF OMAHA LIFE INSURANCE COMPANY | 604 | $68K |
| Short-term disability | UNTIED OF OMAHA LIFE INSURANCE COMPANY | 105 | $89K |
| Long-term disability | UNTIED OF OMAHA LIFE INSURANCE COMPANY | 605 | $95K |
| Other(5 contracts) | UNTIED OF OMAHA LIFE INSURANCE COMPANY | 604 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 605 | — |
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.