| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | HCC LIFE INSURANCE COMPANY | $60K | — | $60K | 11.00% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | $22K | — | $22K | 4.00% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $41K | $17K | $58K | 14.18% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $6K | $22K | 14.03% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | EYEMED VISION CARE | $415 | — | $415 | 1.10% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $709 | $4K | 12.13% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $707 | $285 | $992 | 14.02% |
| MMG AGENCY INC.3 Filed as: MMG AGENCY, INC. | 32 BROADWAY, SUITE 1818 NEW YORK, NY 10004 | FEDERAL INSURANCE COMPANY | $968 | — | $968 | 15.00% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | FEDERAL INSURANCE COMPANY | $968 | — | $968 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 MEDICAL ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Insurance mortality and expense charge; Other fees Service code 12 | — | $331K |
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 | 504 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 530 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 1,083 | $532K |
| Vision | EYEMED VISION CARE | 958 | $38K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 504 | $409K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 71 | $158K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 495 | $549K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 504 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,083 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.