| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIASTAR LIFE INSURANCE COMPANY | $15K | — | $15K | 0.38% |
| DAVID M. BANET & ASSOCIATES3 | 45 DOWLIN FORGE ROAD EXTON, PA 19341 | KEYSTONE | $79K | $17K | $96K | 3.11% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $17K | $17K | 0.84% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $11K | $11K | 1.89% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | — | $8K | $8K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 MEDICAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $4.5M |
| BLUECROSS BLUE SHIELD OF GEORGIA EIN 58-1638390 MEDICAL ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $263K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $241K |
| COMPSYCH EIN 36-3739783 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $149K |
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 MEDICAL ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $98K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 RX ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $29K |
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 | 12,457 | 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) | 12,457 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 911 | $11.0M |
| Vision | VISION SERVICE PLAN | 8,627 | $1.3M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 12,457 | $4.1M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 11,517 | $602K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 10,371 | $2.0M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 12,457 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,457 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.