| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | MEDICA INSURANCE COMPANY | $59K | $3K | $62K | 5.23% |
| THE ULTIMATE SOFTWARE GROUP5 Filed as: THE ULTIMATE SOFTWARE GROUP, INC. | P.O. BOX 930953 ATLANTA, GA 31193 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.44% |
| AXA ASSISTANCE, USA5 | 122 S. MICHIGAN AVENUE, SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $251 | $251 | 0.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HWY 169 S SAINT LOUIS PARK, MN 55426 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 14.76% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $46 | $236 | 0.74% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 123042 DALLAS, TX 75312 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $73 | $5K | 23.25% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $718 | $749 | $1K | 7.25% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 123042 DALLAS, TX 75312 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $73 | $3K | 15.39% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $421 | $683 | $1K | 5.83% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 123042 DALLAS, TX 75312 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $73 | $3K | 23.13% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $467 | $534 | $1K | 7.05% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $3K | — | $3K | 23.96% |
| USI INSURANCE SERVICES LLC4 Filed as: USI INS SERVICE NATIONAL INC. | 8331 NORMAN CENTER DRIVE, SUITE 500 BLOOMINGTON, MN 55413 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $364 | — | $364 | 3.17% |
| LOCKTON COMPANIES, LLC4 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $78 | — | $78 | 0.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICA SELF-INSURED EIN 41-1479417 MEDICAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $656K |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 STD/FMLA ADMINISTRATOR | Contract Administrator Service code 13 | — | $46K |
| DDMN ASO, LLC EIN 41-1905554 DENTAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $34K |
| BENEFIT EXTRAS, INC. FSA/HRA ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 1815 BURNSVILLE, MN 55337 | $21K |
| COMPSYCH EIN 35-3739783 ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 782 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 788 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 324 | $53K |
| Vision | EYEMED VISION CARE | 916 | $39K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,040 | $453K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,040 | $453K |
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 1,418 | $1.2M |
| Other(5 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,040 | $535K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,418 | — |
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.