| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 525 WEST MONROE STREET, SUITE 600 CHICAGO, IL 60661 | BLUECROSS BLUESHIELD OF ILLINOIS | $51K | $4K | $55K | 1.66% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE, SUITE 3400 CHICAGO, IL 60661 | DELTA DENTAL OF ILLINOIS | $28K | — | $28K | 8.00% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $11K | 12.94% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 13.10% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE, SUITE 3400 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 13.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE CO. EIN 47-0322111 ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
| LOCKTON COMPANIES EIN 20-3354970 BROKER | Insurance agents and brokers Service code 22 | — | $1K |
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 | 399 | 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) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 837 | $3.3M |
| Dental | DELTA DENTAL OF ILLINOIS | 941 | $354K |
| Vision | EYEMED VISION CARE | 921 | $32K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 399 | $34K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 399 | $63K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 837 | $3.3M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 399 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 941 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.