| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARTIN INSURANCE GROUP3 Filed as: MARTIN RAY MIRACLE | 840 GESSNER ROAD, SUITE 600 HOUSTON, TX 77024 | HIGHMARK, INC. | $81K | $0 | $81K | 3.10% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 10.29% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA INSURANCE COMPANY | $5K | $0 | $5K | 4.87% |
| MARTY MIRACLE3 | 9811 KATY FREEWAY SUITE 500 HOUSTON, TX 77024 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $479 | $0 | $479 | 4.00% |
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 | 293 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 432 | $2.6M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 428 | $99K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 555 | $12K |
| Life insurance | BOSTON MUTUAL LIFE INSURANCE COMPANY | 272 | $106K |
| Short-term disability | BOSTON MUTUAL LIFE INSURANCE COMPANY | 272 | $106K |
| Long-term disability | BOSTON MUTUAL LIFE INSURANCE COMPANY | 272 | $106K |
| Prescription drug | HIGHMARK, INC. | 432 | $2.6M |
| Other | BOSTON MUTUAL LIFE INSURANCE COMPANY | 272 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 555 | — |
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.