| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON GA - NORTHWEST | 2100 ROSS AVENUE, STE 1200 DALLAS, TX 75201 | TOKIO MARINE HCC LIFE INSURANCE CO. | — | $38K | $38K | 4.98% |
| LOCKTON COMPANIES, LLC3 | BANK OF AMERICA LOCKBOX SERVICES 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $9K | $15K | 4.84% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMANIES LLC | C/O BANK OF AMERICA LOCKBOX SERVICE 15939 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $3K | $9K | 7.09% |
| LOCKTON COMPANIES, LLC3 | BANK OF AMERICA LOCKBOX SERVICES 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $296 | $296 | 1.43% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 111 E KILBOURN AVE STE 825 MILWAUKEE, WI 53202 | HARTFORD LIFE AND ACCIDENT | — | $34 | $34 | 1.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX,INC. EIN 33-0441200 PHARMACY BENEFIT MANAGE | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $1.5M |
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $321K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $21K |
| MATRIX ABSENCE MANAGEMENT, INC EIN 77-0493584 CLAIMS PROCESSING | Claims processing Service code 12 | — | $14K |
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 | 545 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 63 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 608 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 665 | $303K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 665 | $303K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 579 | $120K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC LIFE INSURANCE CO. | 525 | $768K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 665 | $325K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 665 | — |
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.