| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | THREE EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | BLUE CROSS OF CALIFORNIA | $110K | $2K | $113K | 4.99% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 11.00% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.20% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION, INC. | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $909 | $909 | 1.10% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $2K | — | $2K | 10.04% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. OF NY | $179 | $0 | $179 | 10.50% |
No Schedule C service providers reported on this filing.
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 182 | $2.3M |
| Dental | BLUE CROSS OF CALIFORNIA | 182 | $2.3M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 89 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $82K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $82K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $82K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 182 | $2.3M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 182 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.