| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE ONE MANAGEMENT INC3 | 1309 W WALL ST MIDLAND, TX 79701 | GUARDIAN | $13K | — | $13K | — |
| INSURANCE ONE MANAGEMENT INC3 | 1309 W WALL ST MIDLAND, TX 79701 | BLUE CROSS BLUE SHIELD | $87K | $18K | $105K | — |
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 | 369 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 369 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 369 | $0 |
| Dental | BLUE CROSS BLUE SHIELD | 369 | $0 |
| Vision | GUARDIAN | 427 | $0 |
| Prescription drug | BLUE CROSS BLUE SHIELD | 369 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD | 369 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 427 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.