| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $10K | $10K | 1.65% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 0.73% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $441 | $441 | 0.73% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $2K | — | $2K | 4.17% |
| DAVID PRATHER3 | 228 JESSE JAMES RD, STE. D EXCELSIOR SPRINGS, MO 64024 | AFLAC | $672 | — | $672 | 2.01% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AFLAC | $613 | — | $613 | 1.84% |
| TIFFANY S HERMSEN3 Filed as: TIFFANY S. HERMSEN | 2404 NE 79TH PL KANSAS CITY, MO 64118 | AFLAC | $537 | — | $537 | 1.61% |
| TARA M HELLER3 | 10428 N POTTER AVE KANSAS CITY, MO 64157 | AFLAC | $327 | — | $327 | 0.98% |
| KRISTI L HARSHBARGER3 Filed as: KRISTI HARSHBARGER | 220 W ILLINOIS ST, UNIT 1201 CHICAGO, IL 60654 | AFLAC | $272 | — | $272 | 0.81% |
| CARISSA KING3 | 301 E EXCELSIOR STREET EXCELSIOR SPRINGS, MO 64024 | AFLAC | $268 | — | $268 | 0.80% |
| TABELLO INS SERVICES INC3 | 1461 SIERRA VISTA DR LA HABRA, CA 90631 | AFLAC | $212 | — | $212 | 0.63% |
| THE LUTHER GROUP LLC3 | 6525 NW MELODY COURT PARKVILLE, MO 64152 | AFLAC | $190 | — | $190 | 0.57% |
| SHANNON N SMITH3 | 1525 SE PICCADILLY ST BLUE SPRINGS, MO 64014 | AFLAC | $167 | — | $167 | 0.50% |
| DANA HOWARD3 | 601 SE 3RD ST LEES SUMMIT, MO 64063 | AFLAC | $157 | — | $157 | 0.47% |
| MINDY SKIDMORE LLC3 | 2301 BURLINGTON STREET, SUITE 200 NORTH KANSAS CITY, MO 64116 | AFLAC | $154 | — | $154 | 0.46% |
| LINDEE M WARD3 | 6522 W HIDDEN VALLEY ROAD PARKVILLE, MO 64152 | AFLAC | $122 | — | $122 | 0.37% |
| KYLE J HARRIS3 | 18591 AZTEC DR SPRING LAKE, MI 49456 | AFLAC | $102 | — | $102 | 0.31% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGEL | 1701 W. WEBSTER AVE., UNIT 509 CHICAGO, IL 60614 | AFLAC | $98 | — | $98 | 0.29% |
| RUSSELL BENJAMIN JOHNSON3 | 505 S POLK ST ALBANY, MO 64402 | AFLAC | $92 | — | $92 | 0.28% |
| LISA K ARELLANO3 | 2982 SAN FERNASO ST MINDEN, NV 89423 | AFLAC | $80 | — | $80 | 0.24% |
| MELANIE BARRETT KING3 | 1321 GLEN CEDARS DR MABLETON, GA 30126 | AFLAC | $75 | — | $75 | 0.22% |
| JOANNA M ROCKWELL3 Filed as: JOANNA M NASCA | 350 N LA SALLE DR., STE. 1410 CHICAGO, IL 60654 | AFLAC | $70 | — | $70 | 0.21% |
| DANIEL E ZECKMAN3 | 1275 SHILOH RD, NW STE 2260 KENNESAW, GA 30144 | AFLAC | $64 | — | $64 | 0.19% |
| TERRANCE GREENE3 | 11318 WOODWARD ST OVERLAND PARK, KS 66210 | AFLAC | $61 | — | $61 | 0.18% |
| JOHNATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DR CYPRESS, CA 90630 | AFLAC | $58 | — | $58 | 0.17% |
| AMY LORRAINE LUTHER3 | 6620 NW DEARING DR PARKVILLE, MO 64152 | AFLAC | $54 | — | $54 | 0.16% |
| ROBERT TORRES3 | 68 BROOKVIEW LN POTTSTOWN, PA 19464 | AFLAC | $41 | — | $41 | 0.12% |
| RONALD ALLEN JONES3 | 2935 PERIMETER CIR BUFORD, GA 30519 | AFLAC | $36 | — | $36 | 0.11% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $35 | — | $35 | 0.10% |
| LAURIE SOUTHERN3 Filed as: LAURIE L SOUTHERN | 752 MCCONNELL RD POWDER SPRINGS, GA 30127 | AFLAC | $35 | — | $35 | 0.10% |
| CAROL S JOSSERAND3 | 1391 VALDARNO DR GREENWOOD, IN 46143 | AFLAC | $33 | — | $33 | 0.10% |
| JOHN P KOWN II3 | 430 DAVIS CARNES LN NW MARIETTA, GA 30064 | AFLAC | $31 | — | $31 | 0.09% |
| DARLENE MCGRAW3 Filed as: DARLENE R MCGRAW | 2130 MACKINTOSH CT MANHATTAN, KS 66503 | AFLAC | $29 | — | $29 | 0.09% |
| DORIS L BRACKETT3 | 3233 HIGHGATE CHASE CT BERKELEY LAKE, GA 30092 | AFLAC | $20 | — | $20 | 0.06% |
| CHAD J BASLER3 | 460 NE LAKES EDGE DR LEES SUMMIT, MO 64064 | AFLAC | $16 | — | $16 | 0.05% |
| THOMAS S GENTZ3 | 3848 CHERRY BROOK LN MASON, OH 45040 | AFLAC | $15 | — | $15 | 0.04% |
| ROBERT F LANSFORD3 | 5018 AMBER WAY NW ACWORTH, GA 30102 | AFLAC | $14 | — | $14 | 0.04% |
| GWEN AYLWARD3 Filed as: GWEN A AYLWARD | 27777 LANDMARK DR LONGFORD, KS 67458 | AFLAC | $12 | — | $12 | 0.04% |
| TIMOTHY B ASBY3 | 11500 GOLDEN WILLOW CT ZIONSVILLE, IN 46077 | AFLAC | $11 | — | $11 | 0.03% |
| ROCKWELL & ASSOCIATES3 Filed as: ROCKWELL & ASSOCIATES LTD | 325 W HURON ST., STE 215 CHICAGO, IL 60654 | AFLAC | $9 | — | $9 | 0.03% |
| JEREMY FRYE & ASSOCIATES INC3 Filed as: JEREMY J FRYE | 1508 N CHURCH RD STE B LIBERTY, MO 64068 | AFLAC | $8 | — | $8 | 0.02% |
| GARY W WARE JR3 | 3103 MEADOWBROOK DR CHAMPAIGN, IL 61822 | AFLAC | $8 | — | $8 | 0.02% |
| K GRAMLICH INC3 | 9131 N BOOTH CT KANSAS CITY, MO 64157 | AFLAC | $7 | — | $7 | 0.02% |
| KERRY R PICKARD3 | 8534 N OVERLAND DR KANSAS CITY, MO 64154 | AFLAC | $7 | — | $7 | 0.02% |
| CAESAR D WILLIAMS JR3 | 325 CHESTNUT ST., STE 8 PHILADELPHIA, PA 19106 | AFLAC | $7 | — | $7 | 0.02% |
| PENNY K WRIGHT3 | 308 NE 82ND TER KANSAS CITY, MO 64118 | AFLAC | $7 | — | $7 | 0.02% |
| DEBRA SHERLOCK3 Filed as: DEBRA ANN SHERLOCK | 2219 SUNRISE AVE GRAND ISLAND, NE 68803 | AFLAC | $7 | — | $7 | 0.02% |
| CHAD JOSEPH BASLER3 | 2301 BURLINGTON ST., STE. 200 NORTH KANSAS CITY, MO 64116 | AFLAC | $6 | — | $6 | 0.02% |
| JOSEPH A NASCA3 | 28081 W. MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $6 | — | $6 | 0.02% |
| OWEN JOHNSTON3 | 2414 N TUSTIN AVE, APT 02 SANTA ANA, CA 92705 | AFLAC | $5 | — | $5 | 0.01% |
| ANGELA M STREBY3 | 2504 SW VALLEY RIDGE LN LEES SUMMIT, MO 64082 | AFLAC | $5 | — | $5 | 0.01% |
| JASON A NAVILLE3 | 5511 MOSER KNOB RD FLOYDS KNOBS, IN 47119 | AFLAC | $5 | — | $5 | 0.01% |
| IOANNIS T GRATSINOPOULOS3 | 1893 E DAULBY ST MERIDIAN, ID 83642 | AFLAC | $4 | — | $4 | 0.01% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 321 N CLARK ST, STE. 625 CHICAGO, IL 60654 | AFLAC | $4 | — | $4 | 0.01% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $4 | — | $4 | 0.01% |
| JEREMY FRYE & ASSOCIATES INC3 | 1508 N CHURCH RD STE B LIBERY, MO 64068 | AFLAC | $4 | — | $4 | 0.01% |
| WILLINGHAM INC3 | 35354 MISSION BELLEVIEW RD LOUISBURG, KS 66053 | AFLAC | $4 | — | $4 | 0.01% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $3 | — | $3 | 0.01% |
| BARRY MCPHERSON INC3 | 3928 IRONBARK WAY MCKINNEY, TX 75071 | AFLAC | $2 | — | $2 | 0.01% |
| LLOYD W HUGHES3 | 3775 N STATE ROAD 52 LEBANON, IN 46052 | AFLAC | $2 | — | $2 | 0.01% |
| JACQUELINE GELINAS BEAULIEU3 | 577 MARITIME WAY SUPPLY, NC 28462 | AFLAC | $2 | — | $2 | 0.01% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $2 | — | $2 | 0.01% |
| DUSTIN ROBERT JOHNSON3 | 745 W BROMPTON AVE APT 1 CHICAGO, IL 60657 | AFLAC | $2 | — | $2 | 0.01% |
| RONALD E KIRKLAND3 | 1044 HARBOR RIDGE RD GUNTERSVILLE, AL 35976 | AFLAC | $2 | — | $2 | 0.01% |
| SCOTTI MADISON3 | 3330 COBB PKWY NW STE 324-3 ACWORTH, GA 30101 | AFLAC | $2 | — | $2 | 0.01% |
| STEVEN VORDERLANDWEHR3 | 1018 HIGHGROVE DR MONROE, GA 30655 | AFLAC | $2 | — | $2 | 0.01% |
| TARRAH SMITHSON3 Filed as: TARRAH L SMITHSON | 2145 SAULS PL ALPHARETTA, GA 30004 | AFLAC | $2 | — | $2 | 0.01% |
| CONSTANCE I LAGER3 | 5109 NE 55TH TERRACE KANSAS CITY, MO 64119 | AFLAC | $2 | — | $2 | 0.01% |
| BEAULIEU BENEFITS INC3 | 577 MARITIME WAY SUPPLY, NC 28462 | AFLAC | $2 | — | $2 | 0.01% |
| DALE IRA DAVIS3 | 5892 CEDARCREEK LN LEXINGTON, KY 40515 | AFLAC | $1 | — | $1 | 0.00% |
| DANIEL MARTIN BREDESON3 | 19043 META RD CORNELIUS, NC 28031 | AFLAC | $1 | — | $1 | 0.00% |
| KATHERINE LATIMER3 | 5093 BOONE LINKS LN COLUMBUS, GA 31909 | AFLAC | $1 | — | $1 | 0.00% |
| LANCE OSBORNE3 | 21822 SEACREST LN HUNTINGTON BEACH, CA 92646 | AFLAC | $1 | — | $1 | 0.00% |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $1 | — | $1 | 0.00% |
| DONNA BAILEY3 Filed as: DONNA M BAILEY | 1108 S WESTPORT DRIVE, APT 1 MARSHALL, MO 65340 | AFLAC | $1 | — | $1 | 0.00% |
| JAMES M FLETCHER3 | 7325 CLUBHOUSE DR FORT WAYNE, IN 46838 | AFLAC | $1 | — | $1 | 0.00% |
| JANET ZENTMIRE RIGSBY3 | 801 MELANAE CT LIBERTY, MO 64068 | AFLAC | $1 | — | $1 | 0.00% |
| JOHNATHAN SAMUEL KIRKLAND3 Filed as: JOHNATHAN SAMUAEL KIRKLAND | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $1 | — | $1 | 0.00% |
| ERIC R MACDOUGALL3 Filed as: ERIC MACDOUGALL & ASSOC INC | 5904 MARGARETS WAY NEW HOPE, PA 18938 | AFLAC | $1 | — | $1 | 0.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $104 | $104 | 0.73% |
| LOREAN B HAHN4 | 926 NORTH OVERLOOK DRIVE OLATHE, KS 66061 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 13.11% |
| LOCKTON COMPANIES, LLC4 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $139 | — | $139 | 1.70% |
| THOMAS OWENS4 | PO BOX 781431 WICHITA, KS 67278 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $44 | — | $44 | 0.54% |
| SCOTT SCANTLIN LLC4 | 101 3RD AVENUE W, UNIT 1406 BRADENTON, FL 34205 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $21 | — | $21 | 0.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Other services; Float revenue; Contract Administrator; Direct payment from the plan; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $173K |
| TRIA HEALTH, LLC EIN 27-1515235 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $15K |
| EVERNORTH BEHAVIORAL HEALTH, INC. EIN 41-1648670 ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $10K |
| 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 |
| LOCKTON COMPANIES, LLC BROKER | Insurance agents and brokers Service code 22 | 444 WEST 47TH ST, 900 KANSAS CITY, MO 64112 | $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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 39 | $33K |
| Vision | VISION SERVICE PLAN | 226 | $47K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 449 | $264K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 331 | $61K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 512 | $628K |
| Other(3 contracts, 3 carriers) | FIRST STOP HEALTH - NAZDAR | 331 | $45K |
| 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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.