| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST #900 KANSAS CITY, MO 64112 | SECURIAN LIFE INSURANCE COMPANY | — | $10K | $10K | 1.30% |
| AMERICAN BENEFITS CONSULTING LLC3 | 99 PARK AVENUE 25TH FLOOR NEW YORK, NY 10016 | SECURIAN LIFE INSURANCE COMPANY | — | $8K | $8K | 1.08% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | SUN LIFE ASSURANCE COMPANY OF CANADA | $52K | — | $52K | 9.44% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP COPORATE SERVICES NY LLC | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10017 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $23K | $23K | 4.08% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY # 2-125 AUSTIN, TX 78746 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $428 | $428 | 0.08% |
| AMERICAN BENEFITS & COMP SYSTEMS3 | 99 PARK AVE, 25TH FLOOR NEW YORK, NY 10016 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $6K | $6K | 1.59% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $1K | $1K | 0.29% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST #900 KANSAS CITY, MO 64112 | SECURIAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.30% |
| AMERICAN BENEFITS CONSULTING LLC3 | 99 PARK AVENUE 25TH FLOOR NEW YORK, NY 10016 | SECURIAN LIFE INSURANCE COMPANY | — | $4K | $4K | 1.08% |
| AMERICAN BENEFITS & COMP SYSTEMS3 | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $511 | $511 | 0.35% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST #900 KANSAS CITY, MO 64112 | SECURIAN LIFE INSURANCE COMPANY | — | $839 | $839 | 1.27% |
| AMERICAN BENEFITS CONSULTING LLC3 | 99 PARK AVENUE 25TH FLOOR NEW YORK, NY 10016 | SECURIAN LIFE INSURANCE COMPANY | — | $700 | $700 | 1.06% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH @ WORK SOLUTIONS | PO BOX 14496 DES MOINES, IA 50306 | HYATT LEGAL PLANS | — | $276 | $276 | 14.15% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | PO BOX 310502 DES MOINES, IA 503310502 | HYATT LEGAL PLANS | $167 | — | $167 | 8.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN, INC. EIN 41-0984460 INSURANCE CARRIER | Contract Administrator; Claims processing; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.0M |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 PLAN ADMINISTRATOR | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | — | $708K |
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $53K |
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 | 4,047 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 140 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSMN, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 4,117 | $0 |
| Dental | DDMN ASO, LLC | 5,870 | $1.3M |
| Vision | VISION SERVICE PLAN | 2,582 | $307K |
| Life insurance(3 contracts) | SECURIAN LIFE INSURANCE COMPANY | 4,047 | $1.2M |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,157 | $147K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,644 | $405K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,879 | $551K |
| Other(2 contracts, 2 carriers) | AETNA BEHAVIORAL HEALTH, LLC | 4,518 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,870 | — |
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.