| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | UNKNOWN UNKNOWN DALLAS, TX 75248 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | $7K | $42K | 11.34% |
| UNKNOWN3 | UNKNOWN DALLAS, TX 75248 | BLUE CROSS BLUE SHIELD OF TEXAS | $9K | — | $9K | 6.82% |
| LOCKTON COMPANIES, LLC3 | 525 WEST MONROE, SUITE 600 CHICAGO, IL 60661 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $3K | $8K | 15.72% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3500 CHICAGO, IL 60661 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.52% |
| MARK METTILLE3 Filed as: MARK C. PIETSCH | 10816 CRYSTAL SPRINGS LANE ORLAND PARK, IL 60467 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $65 | — | $65 | 0.13% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | HM LIFE INSURANCE COMPANY | $905 | — | $905 | 10.00% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $368K |
| Dental | BLUE CROSS BLUE SHIELD OF TEXAS | 255 | $129K |
| Vision | HM LIFE INSURANCE COMPANY | 105 | $9K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 82 | $50K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 82 | $50K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 82 | $50K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $368K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 82 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.