| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLJM LLC3 | 8235 FORSYTH BLVD SUITE 1200 SAINT LOUIS, MO 63105 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 1.85% |
| CLJM LLC3 | 8235 FORSYTH BLVD SUITE 1200 SAINT LOUIS, MO 63105 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | 0.00% |
| CLJM LLC3 | 8235 FORSYTH BLVD STE 1200 CLAYTON, MO 631051643 | VISION SERVICE PLAN | $1K | — | $1K | 7.91% |
| CLJM LLC3 | 8235 FORSYTH BLVD SUITE 1200 SAINT LOUIS, MO 63105 | HARTFORD LIFE AND ACCIDENT | $660 | $56 | $716 | 16.27% |
| CLJM LLC3 | 8235 FORSYTH BLVD STE 1200 ST LOUIS, MO 63105 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | 0.00% |
| CLJM LLC3 | 8235 FORSYTH BLVD SUITE 1200 SAINT LOUIS, MO 63105 | HARTFORD LIFE AND ACCIDENT | $0 | -$2 | -$2 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $285K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $17K |
| CLJM LLC EIN 35-2232153 BROKER | Other commissions Service code 55 | 8235 FORSYTH BLVD, STE 1200 CLAYTON, MO 63105 | $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 | 704 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 733 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 36 | $2.4M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 36 | $2.3M |
| Vision(2 contracts) | VISION SERVICE PLAN | 321 | $31K |
| Life insurance(6 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 616 | $203K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 146 | $47K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 146 | $47K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 36 | $2.3M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 316 | $345K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 146 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 616 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.