| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 1185 AVENUE OF THE AMERICAS SUITE 2010 NEW YORK, NY 10036 | COMPANION LIFE INSURANCE COMPANY | $37K | $0 | $37K | 4.81% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES, LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | COMPANION LIFE INSURANCE COMPANY | $0 | $17K | $17K | 2.23% |
| LOCKTON COMPANIES, LLC3 | 1185 AVENUE OF THE AMERICAS SUITE 2010 NEW YORK, NY 10036 | MUTUAL OF OMAHA INSURANCE COMPANY | $51K | $0 | $51K | 15.09% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $11K | $11K | 3.13% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES, LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $7K | $7K | 2.16% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO. OF NY | $8K | — | $8K | 9.95% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $2K | $6K | 10.83% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $7K | $0 | $7K | 30.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | $0 | $2K | $2K | 20.00% |
| LOCKTON COMPANIES, LLC3 | 1185 AVENUE OF THE AMERICAS SUITE 2010 NEW YORK, NY 10036 | EVERNORTH CARE SOLUTIONS, INC. | $386 | $0 | $386 | 5.00% |
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 | 664 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 687 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 27 | $197K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO. OF NY | 1,115 | $78K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 864 | $1.1M |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 664 | $339K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 27 | $197K |
| Other(5 contracts, 5 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 1,125 | $433K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,125 | — |
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.