| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 | 221 SOUTH WARREN STREET, SUITE 100 SYRACUSE, NY 13202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $55K | — | $55K | 11.61% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANY, LLC | PO BOX 173850, DEPT 999228 DENVER, CO 80217 | SUN LIFE ASSURANCE COMPANY OF CANADA | $16K | — | $16K | 3.39% |
| CROWN RISK MANAGEMENT, LLC3 | 221 SOUTH WARREN STREET, SUITE 100 SYRACUSE, NY 13202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 7.39% |
| LOCKTON COMPANIES, LLC3 | PO BOX 173850, DEPT 999228 DENVER, CO 80217 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 2.61% |
| CROWN RISK MANAGEMENT, LLC3 | 221 SOUTH WARREN STREET, SUITE 100 SYRACUSE, NY 13202 | DENTAL DENTAL OF MISSOURI | $9K | — | $9K | 8.54% |
| LOCKTON COMPANIES, LLC3 | 3 CITY PLACE DRIVE, SUITE 900 ST. LOUIS, MO 63141 | DENTAL DENTAL OF MISSOURI | $2K | — | $2K | 1.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFITS MGR | Other fees; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $255K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $186K |
| CROWN RISK MANAGEMENT, LLC EIN 20-2318765 BROKER | Other commissions Service code 55 | 221 SOUTH WARREN STREET, SUITE 100 SYRACUSE, NY 13202 | $36K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | PO BOX 505115 ST. LOUIS, MO 631505115 | $11K |
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 | 227 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL DENTAL OF MISSOURI | 391 | $110K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 222 | $30K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $127K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $127K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $127K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 236 | $470K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.