| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIGHTLINE DEALER ADVISORS, LLC3 Filed as: BRIGHTLINE INSURANCE SERVICES, LLC | 14131 MIDWAY RD ADDISON, TX 75001 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 7.47% |
| BRIGHTLINE DEALER ADVISORS, LLC3 Filed as: BRIGHTLINE DEALER ADVISORS LLC | 153001 DALLAS PARKWAY ADDISON, TX 75001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 8.75% |
| ERIKA BROUSSARD3 | 431 SILVER CREEK CIR RICHMOND, TX 77406 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 8.74% |
| DARIN POTTS3 | 100 DETERING ST APT 2128 HOUSTON, TX 77007 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $993 | $2K | 4.54% |
| BOWLES INSURANCE SERVICES LLC3 | 12816 S WINDING PINES DR TOMBALL, TX 77375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $481 | $2K | 3.39% |
| CAROL JEAN HALL3 | 5737 E CHAPTER DR TUCSON, AZ 85708 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $729 | $16 | $745 | 1.66% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO TUCSON, AZ 85747 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $739 | $3 | $742 | 1.65% |
| KURZ & VALDEZ BENEFIT ENROLLMENT SO3 | 14640 N 90TH DR PEORIA, AZ 85381 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $218 | $430 | $648 | 1.44% |
| PAUL A BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $509 | $0 | $509 | 1.13% |
| RICHARD SCHWAGER3 | 2210 VILLAGE DALE AVE HOUSTON, TX 77059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $474 | $31 | $505 | 1.12% |
| R AND T FIGUEROA LLC3 | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $470 | $13 | $483 | 1.07% |
| STEVEN ROBERT KURZ3 | 14640 N 90TH DR PEORIA, AZ 85381 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $26 | $39 | 0.09% |
| CAMILLE HOLLAN SIDEL POTTS3 | 100 DETERING ST APT 2128 HOUSTON, TX 77007 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 0.08% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $161K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $161K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $161K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $161K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $161K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.