| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | HCC LIFE INSURANCE COMPANY | $32K | — | $32K | 11.00% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | $12K | — | $12K | 4.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $9K | 13.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $9K |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 142 | $2.9M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 204 | $72K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 204 | $72K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 142 | $2.9M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 153 | $290K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 204 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.