| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | $20K | $46K | 4.42% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIASTAR LIFE INSURANCE COMPANY | $25K | $22K | $47K | 4.65% |
| EMPYREAN INSURANCE SERVICES, INC.5 | 9009 WEST LOOP S., SUITE 600 HOUSTON, TX 77096 | RELIASTAR LIFE INSURANCE COMPANY | — | $20K | $20K | 2.00% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $6K | $13K | 4.74% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 8.67% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $626 | $2K | 1.38% |
| MCCONKEY BENEFITS & FINANCIAL SERV3 Filed as: MCCONKEY BENEFITS FINANCIAL SERVICE | 2555 KINGSTON ROAD, SUITE 100 YORK, PA 17402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $993 | — | $993 | 0.76% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $354 | $52 | $406 | 8.73% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $265 | — | $265 | 5.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 MEDICAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $2.0M |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 DENTAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $86K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $30K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,500 | $319K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 4,040 | $1.0M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,750 | $1.0M |
| Long-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,067 | $407K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 4,300 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,300 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.