| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAMS, JESS B3 | 1303 E MOCKINGBIRD LANE VICTORIA, TX 770942150 | HUMANA HEALTH PLAN OF TEXAS INC | $42K | $686 | $43K | 3.07% |
| ACRISURE LLC3 | 35000 KAISER COURT SUITE 300 WILLOUGHBY, OH 440943384 | HUMANA HEALTH PLAN OF TEXAS INC | $27K | — | $27K | 1.95% |
| ACRISURE LLC3 | 1303 EAST MOCKINGBIRD LANE VICTORIA, TX 77904 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | $8K | $27K | 25.01% |
| JESS B WILLIAMS3 Filed as: JESS BURKETT WILLIAMS | 102 TURTLE ROCK DR VICTORIA, TX 77904 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.29% |
| WILLIAMS, JESS B3 | 1303 E MOCKINGBIRD VICTORIA, TX 779042150 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 8.71% |
| ACRISURE LLC3 | 35000 KAISER COURT SUITE 300 WILLOUGHBY, OH 440943384 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 5.58% |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLAN OF TEXAS INC | 146 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $107K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $107K |
| Life insurance | HUMANA INSURANCE COMPANY | 211 | $48K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 211 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.