| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | $8K | $30K | 5.11% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | DELTA DENTAL OF MISSOURI | — | $683 | $683 | 0.32% |
| ROBERT MILLER3 Filed as: ROBERT MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | DELTA DENTAL OF MISSOURI | — | $417 | $417 | 0.20% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $975 | — | $975 | 0.66% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $92 | $92 | 0.06% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Claims processing Service code 12 | — | $120K |
| PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 STD ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
| CAREWORKS ABSENCE MANAGEMENT FMLA ADMINISTRATOR | Contract Administrator Service code 13 | 5500 GLENDON COURT DUBLIN, OH 43016 | $7K |
| DISCOVERY BENEFITS EIN 90-0058554 FSA ADMINISTRATOR | Contract Administrator Service code 13 | — | $6K |
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 | 239 | 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) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MISSOURI | 564 | $214K |
| Vision | VISION SERVICE PLAN | 200 | $32K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 274 | $149K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 274 | $149K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 529 | $589K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,043 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,043 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.