| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $330 | $4K | 15.55% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $345 | $3K | 17.64% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HYATT LEGAL PLANS | $860 | $152 | $1K | 12.05% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | MONUMENTAL LIFE INSURANCE COMPANY | $234 | — | $234 | 4.99% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | MONUMENTAL LIFE INSURANCE COMPANY | $102 | — | $102 | 2.43% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | MONUMENTAL LIFE INSURANCE COMPANY | $110 | — | $110 | 3.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF GA EIN 58-0469845 ADMINISTRATOR | Claims processing; Other services; Float revenue; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $521K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $242K |
| EXPRESS SCRIPTS, INC. EIN 16-1279199 RX ADMINISTRATOR | Float revenue; Consulting (general); Contract Administrator; Claims processing Service code 12 | — | $51K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 INSURANCE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $23K |
| VISION SERVICE PLAN EIN 36-3560825 ADMINISTRATOR | Contract Administrator Service code 13 | — | $14K |
| DISCOVERY BENEFITS ADMINISTRATOR | Contract Administrator Service code 13 | 4321 20TH AVENUE SW 866-451-3399 FARGO, ND 58103 | $6K |
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 | 235 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | MONUMENTAL LIFE INSURANCE COMPANY | 8 | $12K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 235 | $30K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 51 | $17K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $47K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 179 | $103K |
| Other(6 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 431 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 431 | — |
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.