| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 WEST 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $28K | $0 | $28K | 5.85% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 1185 AVENUE OF THE AMERICAS SUITE 2010 NEW YORK, NY 10036 | DELTA DENTAL OF COLORADO | $824 | $0 | $824 | 2.09% |
| CL SCOTT CORPORATE INSURANCE SVCS3 Filed as: CL SCOTT CORPORATE INSURANCE | 3600 N CAPITAL OF TEXAS HWY BLDG. B, SUITE 200 AUSTIN, TX 78746 | DELTA DENTAL OF COLORADO | $822 | $0 | $822 | 2.08% |
| CL SCOTT CORPORATE INSURANCE SVCS3 Filed as: CL SCOTT CORPORATE INS. SVCS. LLC | 3600 N CAPITAL OF TEXAS HWY BLDG B., SUITE 100 AUSTIN, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $403 | $0 | $403 | 5.02% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 3207 BOSTON, MA 022413207 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $401 | $0 | $401 | 4.99% |
| CL SCOTT CORPORATE INSURANCE SVCS3 Filed as: CL SCOTT CORPORATE INS. SVCS. LLC | 3600 N CAPITAL OF TEXAS HWY BLDG. B, SUITE 100 AUSTIN, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $432 | $0 | $432 | 5.45% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | PO BOX 3207 BOSTON, MA 022413207 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $362 | $0 | $362 | 4.56% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | PO BOX 3207 BOSTON, MA 022417484 | EYEMED VISION CARE | $600 | $0 | $600 | 7.68% |
| CL SCOTT CORPORATE INSURANCE SVCS3 Filed as: CL SCOTT CORPORATE INS. SVCS. LLC | 3600 N CAPITAL OF TEXAS HWY BLDG. B, SUITE 200 AUSTIN, TX 787463314 | EYEMED VISION CARE | $468 | $0 | $468 | 5.99% |
| OCI INSURANCE & FINANCIAL SERVICES3 | 17445 ARBOR STREET SUIET 300 OMAHA, NE 68130 | EYEMED VISION CARE | $105 | $0 | $105 | 1.34% |
| CL SCOTT CORPORATE INSURANCE SVCS3 Filed as: CL SCOTT CORPORATE INS. SVCS. LLC | 3600 N CAPITAL OF TEXAS HWY BLDG. B, SUITE 100 AUSTIN, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $616 | $0 | $616 | 8.40% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 3207 BOSTON, MA 022413207 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $484 | $0 | $484 | 6.60% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 113 | $482K |
| Dental | DELTA DENTAL OF COLORADO | 113 | $39K |
| Vision | EYEMED VISION CARE | 92 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $8K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $7K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.
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.