| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $85K | — | $85K | 19.43% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 600 CHICAGO, IL 60661 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | — | $22K | 9.93% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $178 | $10K | 17.83% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | 5310 CLARK ROAD, SUITE 1 SARASOTA, FL 34233 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $884 | $884 | 1.65% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $104 | $6K | 17.76% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | 5310 CLARK ROAD, SUITE 1 SARASOTA, FL 34233 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $584 | $584 | 1.82% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $86 | $5K | 17.84% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | 5310 CLARK ROAD, SUITE 1 SARASOTA, FL 34233 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $419 | $419 | 1.63% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $626 | $12 | $638 | 17.95% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | 5310 CLARK ROAD, SUITE 1 SARASOTA, FL 34233 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $67 | $67 | 1.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 MEDICAL ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $68K |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 222 | $439K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $224K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $224K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $32K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $54K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $26K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.