Form 5500 · Employee benefit plan · SAN ANTONIO, TX
THE SAN ANTONIO COUNTRY CLUB
The filing calls this plan THE SAN ANTONIO COUNTRY CLUB HEALTH AND WELFARE PLAN.
Public Form 5500 records show how THE SAN ANTONIO COUNTRY CLUB of SAN ANTONIO, TX, a other services employer, structures its employee benefits. Its broker of record is HUB INTERNATIONAL TEXAS, INC.. Coverage is written through BLUECROSS BLUESHIELD OF TEXAS and 3 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 74-0878940 · plan 501 · plan year 2025, filed Mar 2, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 10 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF TEXAS, covers 234 people.
Reported premium across the insured contracts is $1,785,004, with $84,203 in disclosed broker commissions — about 4.7% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
HUB INTERNATIONAL TEXAS, INC. is the broker of record on all 10 contracts.
4 carriers appear on the filing, including BLUECROSS BLUESHIELD OF TEXAS, UNITED OF OMAHA LIFE INSURANCE COMPANY, MEDICAL AIR SERVICES ASSOCIATION, INC. and COMBINED INSURANCE COMPANY. BLUECROSS BLUESHIELD OF TEXAS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TEXAS | Health, Dental | 234 | Oct 1, 2025 | $1,636,491 | $60,249 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 52 | Oct 1, 2025 | $33,251 | $6,983 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 67 | Oct 1, 2025 | $24,532 | $4,416 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 184 | Oct 1, 2025 | $21,336 | $3,200 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 46 | Oct 1, 2025 | $17,998 | $2,700 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 74 | Oct 1, 2025 | $15,312 | $2,297 |
| MEDICAL AIR SERVICES ASSOCIATION, INC. | Health | 119 | Oct 1, 2025 | $9,583 | $1,917 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Vision | 133 | Oct 1, 2025 | $15,906 | $1,591 |
| COMBINED INSURANCE COMPANY | — | 3 | Oct 1, 2025 | $3,694 | $850 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 12 | Oct 1, 2025 | $6,901 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
Subscribers see how this compares with similar plans in Texas. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Texas — largest plans, brokers, carriers and renewal months.