| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | P.O. BOX 9207 DES MOINES, IA 503069207 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $109K | — | $109K | 4.30% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 3001 WESTOWN PARKWAY WEST DES MOINES, IA 50266 | KAISER FOUNDATION HEALTH PLAN INC | $24K | — | $24K | 3.49% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $6K | $16K | 16.05% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $5K | $17K | 20.41% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | VISION SERVICE PLAN | $2K | — | $2K | 2.95% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $3K | $9K | 15.81% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.30% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $168 | $1K | 3.87% |
| JOE FERNANDEZ3 | 1201 ELM ST STE 4250 DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $888 | $109 | $997 | 3.09% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $547 | $95 | $642 | 1.99% |
| RYAN THURSTON WHITTAKER3 | 33011 COMMODORE CT SAN JUAN CAPO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $569 | — | $569 | 1.76% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $303 | $161 | $464 | 1.44% |
| SADIE BLACKMON3 | 627 RAPIDS RD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $176 | — | $176 | 0.55% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH ST VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $65 | $122 | 0.38% |
| ANDRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 0.32% |
| UZIEL RIVERA3 | 543 CHEROKEE CIRCLE BANNING, CA 92220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.24% |
| MARCEL JAMES MUELLER3 | 6664 RICHMOND DR FRISCO, TX 75035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.21% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 32101 FALL RIVER ROAD TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.17% |
| ZULMA YESENIA MAZARIEGOS3 | 100 WEST MIDWAY DRIVE ANAHEIM, CA 92805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.17% |
| DAVID J MCCLELLAN3 Filed as: DAVID ALLEN NEEL | 1201 ELM STREET DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $2 | $52 | 0.16% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.12% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $10 | $39 | 0.12% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON ST FILLMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.11% |
| PATRICK IAN WAGNER3 | 4580 PEBBLE BROOK LANE PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $3 | $31 | 0.10% |
| STEPHEN W DOUGLASS3 | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $1 | $26 | 0.08% |
| LAMBERT MONTALBO3 | 26197 MIRADO ST HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.03% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 5.35% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $844 | $254 | $1K | 4.78% |
| JOE FERNANDEZ3 | 1201 ELM ST STE 4250 DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $638 | $86 | $724 | 3.15% |
| RYAN THURSTON WHITTAKER3 | 33011 COMMODORE CT SAN JUAN CAPO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $510 | — | $510 | 2.22% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $315 | — | $315 | 1.37% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $172 | $92 | $264 | 1.15% |
| DAVID J MCCLELLAN3 Filed as: DAVID ALLEN NEEL | 1201 ELM STREET DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $144 | $18 | $162 | 0.71% |
| SADIE BLACKMON3 | 627 RAPIDS RD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $141 | — | $141 | 0.61% |
| MARCEL JAMES MUELLER3 | 6664 RICHMOND DR FRISCO, TX 75035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | — | $121 | 0.53% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH ST VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $37 | $69 | 0.30% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 32101 FALL RIVER ROAD TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.22% |
| MARY BETH HARRIS3 | 2633 MILLINGTON DR PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.10% |
| PATRICK IAN WAGNER3 | 4580 PEBBLE BROOK LANE PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $2 | $18 | 0.08% |
| CAPSTONE BENEFIT SOLUTIONS LLC3 | 901 LAKESIDE CIRCLE LEWISVILLE, TX 75057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.04% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON ST FILLMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.03% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 3001 WESTOWN PARKWAY WEST DES MOINES, IA 502661328 | HYATT LEGAL PLANS | $2K | $418 | $3K | 11.96% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $670 | $2K | 21.14% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, INC. | 12712 PARK CENTRAL DRIVE, SUITE 100 DALLAS, TX 75251 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | — | $156 | 20.69% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $18 | $131 | 17.37% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $16 | $46 | 6.10% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $9 | $26 | 3.45% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH ST VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $7 | $13 | 1.72% |
| JOE FERNANDEZ3 | 1201 ELM ST STE 4250 DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $1 | $10 | 1.33% |
| PATRICK IAN WAGNER3 | 4580 PEBBLE BROOK LANE PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DISCOVER BENEFITS EIN 90-0058554 NONE | Contract Administrator Service code 13 | 4321 20TH AVE SW FARGO, ND 58103 | $9K |
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 | 359 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 362 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 717 | $3.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 717 | $2.5M |
| Vision | VISION SERVICE PLAN | 302 | $73K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $84K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $102K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $60K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 717 | $3.2M |
| Other(6 contracts, 4 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 332 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 717 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.