| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 195 SCOTT SWAMP ROAD, SUITE 201 FARMINGTON, CT 06032 | BLUECHOICE HEALTHPLAN | $39K | — | $39K | 2.17% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CONNECTICARE, INC. | — | $60K | $60K | 4.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | AETNA LIFE INSURANCE COMPANY | $103K | $19K | $122K | 9.85% |
| LOCKTON COMPANIES, LLC3 | 195 SCOTT SWAMP ROAD, SUITE 201 FARMINGTON, CT 06302 | AETNA LIFE INSURANCE COMPANY | — | $671 | $671 | 0.05% |
| LOCKTON COMPANIES, LLC3 | 195 SCOTT SWAMP ROAD, SUITE 201 FARMINGTON, CT 06032 | METROPOLITAN LIFE INSURANCE COMPANY | $67K | $43 | $67K | 9.04% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $13K | $13K | 1.73% |
| LOCKTON COMPANIES, LLC3 | 195 SCOTT SWAMP ROAD, SUITE 201 FARMINGTON, CT 06032 | DELTA DENTAL INSURANCE COMPANY | $13K | — | $13K | 2.50% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $11K | — | $11K | 7.00% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.23% |
| ROBERT LUNDE3 | 1938 WESTMINSTER AVENUE COSTA MESA, CA 92627 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.99% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $715 | — | $715 | 1.06% |
| MIKE MCCORMICK3 | 348 SOUTH STRONGS COURT SALT LAKE CITY, UT 84102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $651 | — | $651 | 0.97% |
| MJ INSURANCE3 Filed as: GABRIEL HOLGUIN AND VARIOUS AGENTS | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $171 | — | $171 | 0.25% |
| LUIS ERNESTO PEREZ3 | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 0.13% |
| DAVID ALVARADO3 | 2643 OLD COUNTRY ROAD NEWARK, DE 19702 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 0.11% |
| LOCKTON COMPANIES, LLC3 | 195 SCOTT SWAMP ROAD, SUITE 201 FARMINGTON, CT 06032 | SIMNSA | $3K | — | $3K | 7.00% |
| LOCKTON COMPANIES, LLC3 | 195 SCOTT SWAMP ROAD, SUITE 201 FARMINGTON, CT 06032 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | — | $2K | 13.01% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $583 | $583 | 3.77% |
| RUEBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| LOCKTON COMPANIES, LLC3 | 195 SWAMP SCOTT ROAD FARMINGTON, CT 06032 | FEDERAL INSURANCE COMPANY | $770 | — | $770 | 15.01% |
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 | 2,415 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUECHOICE HEALTHPLAN | 215 | $3.3M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,801 | $1.3M |
| Vision | VISION SERVICE PLAN | 1,135 | $164K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 2,415 | $1.3M |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 2,415 | $1.2M |
| Prescription drug(3 contracts, 3 carriers) | BLUECHOICE HEALTHPLAN | 215 | $3.3M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 2,415 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,415 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.