| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | TOKIO MARINE | — | $33K | $33K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $16K | — | $16K | 12.83% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.83% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL STREET BOSTON, MA 02110 | HARTFORD LIFE AND ACCIDENT | — | $716 | $716 | 0.57% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | EYEMED VISION CARE | $7K | — | $7K | 10.02% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $976 | $976 | 3.59% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| TAMARA L RAYMOND4 | 12343 WEST MCSHANE ROAD FRANKLIN, WI 53132 | PRE-PAID LEGAL INC DBA LEGAL SHIELD | $746 | — | $746 | 8.16% |
| LOCKTON COMPANIES, LLC4 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRE-PAID LEGAL INC DBA LEGAL SHIELD | $286 | — | $286 | 3.13% |
| ROXANE R CHMIELEWSKI4 | 2406 SOUTH 74TH STREET WEST ALLIS, WI 53219 | PRE-PAID LEGAL INC DBA LEGAL SHIELD | $22 | — | $22 | 0.24% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ZURICH AMERICAN INSURANCE COMPANY | $288 | — | $288 | 19.99% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $107 | — | $107 | 10.03% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $55 | — | $55 | 14.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $253K |
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 | 911 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 936 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 564 | $27K |
| Vision | EYEMED VISION CARE | 738 | $73K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 911 | $125K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,012 | $44K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 222 | $54K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 571 | $659K |
| Other(8 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 911 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,012 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.