| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | HIGHMARK INC. | $92 | — | $92 | 0.32% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HIGHMARK INC. | $27 | — | $27 | 0.09% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED CONCORDIA INSURANCE COMPANY | $734 | — | $734 | 3.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 470 ATLANTIC AVENUE, FLOOR 13 BOSTON, MA 02210 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 7.91% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | STANDARD INSURANCE COMPANY | $533 | — | $533 | 3.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 470 ATLANTIC AVENUE, FLOOR 13 BOSTON, MA 02210 | STANDARD INSURANCE COMPANY | $820 | — | $820 | 9.54% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | STANDARD INSURANCE COMPANY | $643 | — | $643 | 7.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 ADMINISTRATOR | Contract Administrator Service code 13 | — | $40K |
| CONCIERGE ADMINISTRATIVE SERVICES ADMINISTRATOR | Contract Administrator Service code 13 | 300 SE FRANK PHILLIPS BARTLESVILLE, OK 74003 | $13K |
| FIRST STAFF BENEFITS BROKER | Insurance agents and brokers Service code 22 | 123 CENTER PARK DR, 127 KNOXVILLE, TN 37922 | $12K |
| LOCKTON COMPANIES, LLC BROKER | Insurance agents and brokers Service code 22 | 444 WEST 47TH STREET KANSAS CITY, MO 64112 | $4K |
| GALLAGHER BENEFITS BROKER | Insurance agents and brokers Service code 22 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | $3K |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 58 | $20K |
| Vision | HIGHMARK INC. | 39 | $29K |
| Life insurance | STANDARD INSURANCE COMPANY | 49 | $14K |
| Long-term disability | STANDARD INSURANCE COMPANY | 49 | $9K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 30 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 58 | — |
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."
No prospect flags tripped on this filing.