| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFIT SERVICES AGENCY | P.O. BOX 868 DELAWARE, OH 43015 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $106 | $5K | 11.34% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.88% |
| PREFERRED BENEFITS SERVICES AGENCY3 | P.O. BOX 868 DELAWARE, OH 43015 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED) | $2K | $0 | $2K | 8.28% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFIT SERVICES AGENCY | P.O. BOX 868 DELAWARE, OH 43015 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $861 | $51 | $912 | 3.93% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $299 | — | $299 | 1.29% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFITS SEVICE AGENCY | P.O. BOX 868 DELAWARE, OH 43015 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $42 | $2K | 11.40% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $717 | — | $717 | 3.82% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BENEFIT SERVICES AGENCY | P.O. BOX 868 DELAWARE, OH 43015 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $20 | $1K | 11.16% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P.O. BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $504 | — | $504 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Other fees; Plan Administrator; Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $111K |
| INFINISOURCE BENEFIT SERVICES NONE | Insurance services Service code 23 | 15 E. WASHINGTON STREET PO BOX 889 COLDWATER, MI 49036 | $660 |
| PREFERRED BENEFITS SERVICES AGENCY NONE | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | P.O. BOX 868 DELAWARE, OH 43015 | $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 | 227 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $82K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED) | 279 | $26K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 227 | $31K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $48K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $23K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (G1728) | 264 | $300K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 85 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.