| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | SUN LIFE ASSURANCE COMPANY OF CANADA | $27K | $2K | $29K | 5.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042, DEPT 3042 DALLAS, TX 75312 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $6K | $6K | 1.04% |
| UMR, INC.3 | 11 SCOTT STREET, SUITE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 0.67% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $2K | — | $2K | 3.24% |
| LOCKTON COMPANIES, LLC3 | 3 CITYPLACE DRIVE, SUITE 900 SAINT LOUIS, MO 63141 | RELIASTAR LIFE INSURANCE COMPANY | $9K | — | $9K | 21.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $273K |
| TELLIGEN INC ADMINISTRATOR | Contract Administrator Service code 13 | 1776 WEST LAKES PARKWAY WEST DES MOINES, IA 50266 | $81K |
| DELTA DENTAL OF IOWA EIN 42-0959302 SERVICE PROVIDER | Contract Administrator; Claims processing Service code 12 | — | $31K |
| TOTAL ADMINISTRATIVE SERVICES CORP EIN 39-1561025 ADMINISTRATOR | Contract Administrator Service code 13 | — | $21K |
| RXBENEFITS, INC. EIN 63-1157085 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
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 | 683 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 693 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 378 | $64K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 490 | $577K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 683 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 683 | — |
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.