| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUECROSS BLUESHIELD OF KANSAS CITY | $30K | $59K | $89K | 3.14% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.00% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $86 | $86 | 0.05% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES, LLC | 1655 RICHOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | — | $137 | $137 | 18.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MISSOURI EIN 43-0908349 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $18K |
| WELLWORKS FOR YOU EIN 26-3082277 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $14K |
| TABEN, LC EIN 48-1197135 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $3K |
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 | 241 | 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) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF KANSAS CITY | 454 | $2.8M |
| Vision | VISION SERVICE PLAN | 215 | $26K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 241 | $176K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 241 | $176K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 241 | $176K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 250 | $177K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.