| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $13K | $13K | 3.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $9K | $9K | 3.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 3.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | PO BOX 2569 BELLAIRE, TX 77402 | EYEMED | — | $9K | $9K | 4.93% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 3.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 5.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 5.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 5.00% |
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 | 2,783 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,813 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3,585 | $1.2M |
| Vision | EYEMED | 2,983 | $178K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,783 | $424K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,783 | $291K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,783 | $180K |
| Other(4 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,783 | $299K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,585 | — |
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."
No prospect flags tripped on this filing.