| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITED 1200 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $328K | $328K | 5.34% |
| RETENTION STRATEGIES INSURANCE CORP4 Filed as: RETENTION STRATEGICS INC. | 409 SAN JORGE SAN JUAN, PR 009123313 | MAPFRE LIFE INSURANCE COMPANY OF PUERTO RICO | $23K | — | $23K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS AND BLUE SHIELD EIN 31-1440175 NONE | Claims processing; Other services Service code 12 | — | $7.4M |
| MATRIX INTEGRATED PSYCHOLOGICAL SER EIN 77-0493584 NONE | Other services Service code 49 | — | $825K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Claims processing; Other services Service code 12 | — | $519K |
| HEALTH ADVOCATE, INC. EIN 23-3080019 NONE | Other services Service code 49 | — | $316K |
| AETNA EIN 06-6033492 NONE | Claims processing; Other services Service code 12 | — | $282K |
| OPTUMRX, INC. EIN 11-2581812 NONE | Claims processing; Other services Service code 12 | — | $218K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $14K |
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 | 24,472 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 126 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 24,598 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 89 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $28K |
| Vision | VISION SERVICE PLAN | 12,406 | $1.8M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 31,711 | $2.3M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 276 | $6.1M |
| Prescription drug(2 contracts, 2 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 89 | $1.2M |
| Other | ARAG INSURANCE COMPANY | 4,556 | $533K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31,711 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.