| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEWITT INSURANCE AGENCY INC3 Filed as: DEWITT INSURANCE AGENCY | 13523 BARRETT PKWY DR SAINT LOUIS, MO 63021 | THE GUARDIAN LIFE INSURANCE COMPANY | $16K | $3K | $20K | 17.41% |
| DEWITT INSURANCE AGENCY INC3 Filed as: DEWITT INSURANCE AGENCY | 13523 BARRETT PKWY DR SAINT LOUIS, MO 63021 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INC EIN 41-1289245 NONE | Claims processing; Other services Service code 12 | — | $771K |
| OPERATING ENGINEERS LOCAL 112 EIN 45-0546196 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $158K |
| GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 NONE | Contract Administrator Service code 13 | — | $113K |
| C.S. MCKEE EIN 25-1900687 NONE | Investment management fees paid directly by plan Service code 51 | — | $78K |
| WOLFE NILGES NAHORSKI, PC EIN 43-1236296 NONE | Accounting (including auditing); Consulting (general) Service code 10 | — | $57K |
| J.W. TERRILL BENEFIT ADMINISTRATORS EIN 43-1254191 NONE | Contract Administrator; Consulting (general) Service code 13 | — | $42K |
| SEGALL BRYANT & HAMILL EIN 41-1788385 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 51 | — | $24K |
| HAMMOND & SHINNERS PC EIN 43-1164305 NONE | Legal Service code 29 | — | $21K |
| INVESTMENT CONSULTING SERVICES, LLC EIN 32-0016703 NONE | Investment management fees paid directly by plan Service code 51 | — | $15K |
| EKON BENEFITS EIN 43-1317863 NONE | Actuarial Service code 11 | — | $10K |
| US BANK NONE | Custodial (securities) Service code 19 | 60 LIVINGSTON AVE ST. PAUL, MN 55107 | $9K |
| CLIFTON LARSON ALLEN LLP EIN 37-0802863 NONE | Accounting (including auditing) Service code 10 | — | $0 |
| CVS/CAREMARK | Claims processing Service code 12 | — | $0 |
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 | 1,044 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,058 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 1,081 | $113K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 1,081 | $113K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,211 | $70K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 1,081 | $113K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 2,641 | $514K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,211 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,641 | — |
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.