| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $39K | $39K | 5.27% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 1.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.24% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSUANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $762 | $762 | 1.21% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $2K | — | $2K | 3.60% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $61 | $61 | 0.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $44 | $44 | 0.30% |
| LOREAN B HAHN4 | 926 NORTH OVERLOOK DRIVE OLATHE, KS 66061 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 8.80% |
| LOCKTON COMPANIES, LLC4 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $279 | — | $279 | 2.18% |
| SCOTT SCANTLIN LLC4 | 101 3RD AVENUE W, UNIT 1406 BRADENTON, FL 34205 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $35 | — | $35 | 0.27% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 20.34% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 20.38% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 20.51% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AFLAC | $118 | — | $118 | 1.70% |
| DAVID PRATHER3 | 610 CLAY STREET CHILLICOTHE, MO 64601 | AFLAC | $90 | — | $90 | 1.30% |
| TIFFANY S HERMSEN3 | 2404 NE 79TH PLACE KANSAS CITY, MO 64118 | AFLAC | $79 | — | $79 | 1.14% |
| KRISTI L HARSHBARGER3 Filed as: KRISTI HARSHBARGER | 220 W ILLINOIS STREET, UNIT 1201 CHICAGO, IL 60654 | AFLAC | $73 | — | $73 | 1.05% |
| TARA M HELLER3 | 10428 N POTTER AVE KANSAS CITY, MO 64157 | AFLAC | $57 | — | $57 | 0.82% |
| CARISSA KING3 | 301 E EXCELSIOR STREET EXCELSIOR SPRINGS, MO 64024 | AFLAC | $52 | — | $52 | 0.75% |
| THE LUTHER GROUP LLC3 Filed as: THE LUTHER GROUP, LLC | 6525 NW MELODY COURT PARKVILLE, MO 64152 | AFLAC | $38 | — | $38 | 0.55% |
| TABELLO INS SERVICES INC3 Filed as: TABELLO INS SERVICE, INC | 1461 SIERRA VISTA DRIVE LA HABRA, CA 90631 | AFLAC | $38 | — | $38 | 0.55% |
| SHANNON N SMITH3 | 1525 SE PICCADILLY STREET BLUE SPRINGS, MO 64014 | AFLAC | $37 | — | $37 | 0.53% |
| DANA HOWARD3 | 601 SE 3RD STREET LEES SUMMIT, MO 64063 | AFLAC | $35 | — | $35 | 0.50% |
| MINDY SKIDMORE LLC3 Filed as: MINDY SKIDMORE, LLC | 2301 BURLINGTON STREET, SUITE 200 NORTH KANSAS CITY, MO 64116 | AFLAC | $30 | — | $30 | 0.43% |
| KYLE J HARRIS3 | 18591 AZTEC DRIVE SPRING LAKE, MI 49456 | AFLAC | $27 | — | $27 | 0.39% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGEL | 1701 W WEBSTER AVENUE, UNIT 509 CHICAGO, IL 60614 | AFLAC | $25 | — | $25 | 0.36% |
| LINDEE M WARD3 | 6522 NW HIDDEN VALLEY ROAD PARKVILLE, MO 64152 | AFLAC | $24 | — | $24 | 0.35% |
| ROBERT F LANSFORD3 | 1592 VALLEY STREAM DRIVE MARIETTA, GA 30062 | AFLAC | $24 | — | $24 | 0.35% |
| DANIEL E ZECKMAN3 | 1275 SHILOH ROAD NW, SUITE 2260 KENNESAW, GA 30144 | AFLAC | $18 | — | $18 | 0.26% |
| JOANNA M ROCKWELL3 Filed as: JOANNA M NASCA | 350 N LA SALLE DRIVE, SUITE 1410 CHICAGO, IL 60654 | AFLAC | $18 | — | $18 | 0.26% |
| MELANIE BARRETT KING3 | 1321 GLEN CEDARS DRIVE MABLETON, GA 30126 | AFLAC | $18 | — | $18 | 0.26% |
| RUSSELL BENJAMIN JOHNSON3 | 505 S POLK STREET ALBANY, MO 64402 | AFLAC | $16 | — | $16 | 0.23% |
| LISA K ARELLANO3 | 2982 SAN FERNANDO DRIVE MINDEN, NV 89423 | AFLAC | $13 | — | $13 | 0.19% |
| ROBERT TORRES3 | 68 BROOKVIEW LANE POTTSTOWN, PA 19464 | AFLAC | $10 | — | $10 | 0.14% |
| TERRANCE GREENE3 | 11318 WOODWARD STREET OVERLAND PARK, KS 66210 | AFLAC | $10 | — | $10 | 0.14% |
| LAURIE SOUTHERN3 Filed as: LAURIE L SOUTHERN | 752 MCCONNELL ROAD POWDER SPRINGS, GA 30127 | AFLAC | $10 | — | $10 | 0.14% |
| JONATHAN ALI HAJIMOMEN3 | 5752 WHISTLER CIRCLE HUNTINGTON BEACH, CA 92649 | AFLAC | $9 | — | $9 | 0.13% |
| JOHN P KOWN II3 Filed as: JOHN P KOWN LL | 430 DAVIS CARNES LN NW MARIETTA, GA 30064 | AFLAC | $9 | — | $9 | 0.13% |
| RONALD ALLEN JONES3 | 2935 PERIMETER CIRCLE BUFORD, GA 30519 | AFLAC | $9 | — | $9 | 0.13% |
| CAROL S JOSSERAND3 | 1391 VALDARNO DRIVE GREENWOOD, IN 46143 | AFLAC | $8 | — | $8 | 0.12% |
| DARLENE MCGRAW3 Filed as: DARLENE R MCGRAW | 2130 MACKINTOSH COURT MANHATTAN, KS 66503 | AFLAC | $7 | — | $7 | 0.10% |
| AMY LORRAINE LUTHER3 | 6525 NW MELODY COURT PARKVILLE, MO 64152 | AFLAC | $6 | — | $6 | 0.09% |
| G SCOTT COOKE3 | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $6 | — | $6 | 0.09% |
| DORIS L BRACKETT3 | 3233 HIGHGATE CHASE COURT BERKELEY LAKE, GA 30092 | AFLAC | $5 | — | $5 | 0.07% |
| CHAD J BASLER3 | 460 NE LAKES EDGE DRIVE LEES SUMMIT, MO 64064 | AFLAC | $3 | — | $3 | 0.04% |
| GWEN AYLWARD3 Filed as: GWEN A AYLWARD | 2777 LANDMARK DRIVE LONGFORD, KS 67458 | AFLAC | $3 | — | $3 | 0.04% |
| THOMAS S GENTZ3 | 3848 CHERRY BROOK LANE MASON, OH 45040 | AFLAC | $2 | — | $2 | 0.03% |
| JEREMY FRYE & ASSOCIATES INC3 Filed as: JEREMY J FRYE | 1508 N CHURCH ROAD, SUITE B LIBERTY, MO 64068 | AFLAC | $2 | — | $2 | 0.03% |
| KERRY R PICKARD3 | 8534 N OVERLAND DRIVE KANSAS CITY, MO 64154 | AFLAC | $2 | — | $2 | 0.03% |
| DEBRA SHERLOCK3 Filed as: DEBRA ANN SHERLOCK | 2219 SUNRISE AVENUE GRAND ISLAND, NE 68803 | AFLAC | $2 | — | $2 | 0.03% |
| TIMOTHY B ASBY3 | 11500 GOLDEN WILLOW COURT ZIONSVILLE, IN 46077 | AFLAC | $2 | — | $2 | 0.03% |
| CAESAR D WILLIAMS JR3 | 325 CHESTNUT STREET, SUITE 8 PHILADELPHIA, PA 19106 | AFLAC | $2 | — | $2 | 0.03% |
| ANGELA M STREBY3 | 2504 SW VALLEY RIDGE LANE LEES SUMMIT, MO 64082 | AFLAC | $2 | — | $2 | 0.03% |
| ROCKWELL & ASSOCIATES3 Filed as: ROCKWELL & ASSOCIATES LTD | 325 W HURON STREET, SUITE 215 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.01% |
| PENNY K WRIGHT3 | 308 NE 82ND TERRACE KANSAS CITY, MO 64118 | AFLAC | $1 | — | $1 | 0.01% |
| K GRAMLICH INC3 Filed as: K GRAMLICH, INC | 9131 N BOOTH COURT KANSAS CITY, MO 64157 | AFLAC | $1 | — | $1 | 0.01% |
| JOSEPH A NASCA3 | 28081 W MAPLE AVENUE BARRINGTON, IL 60010 | AFLAC | $1 | — | $1 | 0.01% |
| JASON A NAVILLE3 | 5511 MOSER KNOB ROAD FLOYDS KNOBS, IN 47119 | AFLAC | $1 | — | $1 | 0.01% |
| CHAD JOSEPH BASLER3 | 2301 BURLINGTON STREET, SUITE 200 NORTH KANSAS CITY, MO 64116 | AFLAC | $1 | — | $1 | 0.01% |
| GARY W WARE JR3 | 3103 MEADOWBROOK DRIVE CHAMPAIGN, IL 61822 | AFLAC | $1 | — | $1 | 0.01% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $1 | — | $1 | 0.01% |
| WILLINGHAM INC3 | 35354 MISSION BELLEVIEW ROAD LOUISBURG, KS 66053 | AFLAC | $1 | — | $1 | 0.01% |
| BEAULIEU BENEFITS INC3 | 577 MARITIME WAY SUPPLY, NC 28462 | AFLAC | $1 | — | $1 | 0.01% |
| IOANNIS T GRATSINOPOULOS3 | 1893 E DAULBY STREET MERIDIAN, ID 83642 | AFLAC | $1 | — | $1 | 0.01% |
| OWEN JOHNSTON3 | 1300 FAIRHAVEN AVENUE, APT 3 SANTA ANA, CA 92705 | AFLAC | $1 | — | $1 | 0.01% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 321 N CLARK STREET, SUITE 625 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.01% |
| JEREMY FRYE & ASSOCIATES INC3 Filed as: JEREMY FRYE & ASSOCIATES, INC | 1508 N CHURCH ROAD, SUITE B LIBERTY, MO 64068 | AFLAC | $1 | — | $1 | 0.01% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $1 | — | $1 | 0.01% |
| RONALD E KIRKLAND3 | 1044 HARBOR RIDGE ROAD GUNTERSVILLE, AL 35976 | AFLAC | $1 | — | $1 | 0.01% |
| LLOYD W HUGHES3 | 3775 N STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $1 | — | $1 | 0.01% |
| DUSTIN ROBERT JOHNSON3 | 58 MODA LANE ATLANTA, GA 30316 | AFLAC | $1 | — | $1 | 0.01% |
| SCOTTI MADISON3 | 3330 COBB PARKWAY NW, SUITE 324-3 ACWORTH, GA 30101 | AFLAC | $1 | — | $1 | 0.01% |
| STEVEN VORDERLANDWEHR3 | 1018 HIGHGROVE DRIVE MONROE, GA 30655 | AFLAC | $1 | — | $1 | 0.01% |
| TARRAH SMITHSON3 Filed as: TARRAH L SMITHSON | 2145 SAULS PLACE ALPHARETTA, GA 30004 | AFLAC | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Named fiduciary; Other services; Non-monetary compensation; Participant communication; Claims processing; Float revenue; Contract Administrator; Direct payment from the plan Service code 12 | — | $311K |
| EVERNORTH CARE SOLUTIONS, INC EIN 86-1465626 ADMINISTRATOR | Claims processing; Contract Administrator; Participant communication; Direct payment from the plan Service code 12 | — | $10K |
| TRIA HEALTH, LLC EIN 27-1515235 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $8K |
| LIFE INSURANCE CO. OF NORTH AMERICA EIN 23-1503749 STD ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
| WEX HEALTH INC. EIN 06-1593514 ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 33 | $7K |
| Vision | VISION SERVICE PLAN | 248 | $48K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 473 | $265K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 345 | $63K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 512 | $741K |
| Other(6 contracts, 4 carriers) | FIRST STOP HEALTH, LLC (NAZDAR) | 345 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 512 | — |
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."
No prospect flags tripped on this filing.