| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMONWEALTH EMPLOYEE BENEFIT SOLUT3 Filed as: COMMONWEALTH BENEFIT SOLUTIONS | 3200 TURTLE NECK RD, STE 101 PORTSMOUTH, VA 23703 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 6.22% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.78% |
| ADVANTAGE INSURANCE SERVICES, INC.3 | 1580 MAKALOA ST, STE 1220 HONOLULU, HI 96814 | UNIVERSITY HEALTH ALLIANCE | $5K | $0 | $5K | 5.00% |
| SHANNON ELISH GLOVER3 | 4113 PENDLETON ROAD PORTSMOUTH, VA 23703 | GUARDIAN LIFE INSURACE COMPANY | $5K | $0 | $5K | 7.66% |
| THE CARSON GROUP INC3 Filed as: THE CARSON GROUP INC. | 1612 MARION STREET, 4TH FL. COLUMBIA, SC 29201 | GUARDIAN LIFE INSURACE COMPANY | $2K | $0 | $2K | 3.89% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | GUARDIAN LIFE INSURACE COMPANY | $1K | $0 | $1K | 2.33% |
| COMMONWEALTH EMPLOYEE BENEFIT SOLUT3 Filed as: COMMONWEALTH BENEFIT SOLUTIONS | 3200 TURTLE NECK RD, STE 101 PORTSMOUTH, VA 23703 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.97% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.03% |
| ADVANTAGE INSURANCE SERVICES, INC.3 | 1580 MAKALOA ST, STE 1220 HONOLULU, HI 96814 | KAISER FOUNDATION HEALTH PLAN, INC. | $899 | $0 | $899 | 3.36% |
| ADVANTAGE INSURANCE SERVICES, INC.3 | 1580 MAKALOA ST, STE 1220 HONOLULU, HI 96814 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.80% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $342 | $0 | $342 | 1.43% |
| ADVANTAGE INSURANCE SERVICES, INC.3 | 1580 MAKALOA ST, STE 1220 HONOLULU, HI 96814 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.80% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $342 | $0 | $342 | 1.43% |
| ADVANTAGE INSURANCE SERVICES, INC.3 | 1580 MAKALOA ST, STE 1220 HONOLULU, HI 96814 | VISION SERVICE PLAN | $744 | $0 | $744 | 7.56% |
| COMMONWEALTH EMPLOYEE BENEFIT SOLUT3 Filed as: COMMONWEALTH BENEFIT SOLUTIONS | 3200 TURTLE NECK RD, STE 101 PORTSMOUTH, VA 23703 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $504 | $0 | $504 | 7.51% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $168 | $0 | $168 | 2.50% |
| ADVANTAGE INSURANCE SERVICES, INC.3 | 1580 MAKALOA ST, STE 1220 HONOLULU, HI 96814 | HARTFORD LIFE AND ACCIDENT | $113 | $0 | $113 | 15.07% |
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 | 129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 46 | $664K |
| Dental | GUARDIAN LIFE INSURACE COMPANY | 107 | $62K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 110 | $118K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $49K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $121K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 17 | $109K |
| Other(4 contracts, 3 carriers) | GUARDIAN LIFE INSURACE COMPANY | 466 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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.