| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 W MONROE SREET, SUITE 3400 CHICAGO, IL 60661 | UNITEDHEALTHCARE INSURANCE COMPANY | $82K | — | $82K | 4.99% |
| LOCKTON COMPANIES, LLC7 | C/O BANK OF AMERICA 15939 COLLECTIONS CTR DR CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $6K | $27K | 6.56% |
| LOCKTON COMPANIES, LLC7 | C/O BANK OF AMERICA 15939 COLLECTIONS CTR DR CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $4K | $14K | 6.62% |
| LOCKTON COMPANIES, LLC3 | 15939 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $8K | — | $8K | 4.59% |
| LOCKTON COMPANIES, LLC7 | C/O BANK OF AMERICA 15939 COLLECTIONS CTR DR CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $1K | $4K | 6.71% |
| LOCKTON COMPANIES, LLC0 | 15939 COLLECTIONS CTR DR CHICAGO, IL 60693 | FOUR EVER LIFE INS CO. | $3K | $0 | $3K | 15.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $541 | — | $541 | 8.45% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $383K |
| LOCKTON COMPANIES LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | 500 W MONROE ST, STE 3400 CHICAGO, IL 606613778 | $137K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 ADMINISTRATOR | Contract Administrator Service code 13 | — | $80K |
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 | 1,822 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,869 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INS CO. | 0 | $22K |
| Vision | VISION SERVICE PLAN | 1,213 | $175K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,675 | $414K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,784 | $217K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 3,520 | $1.6M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,146 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,520 | — |
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.