| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $630 | $630 | 1.23% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 20.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $414 | $414 | 1.12% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $487 | $487 | 1.34% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 20.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 RX BENEFIT MANAGEMENT | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $646K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $118K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Contract Administrator; Non-monetary compensation; Participant communication; Claims processing; Other services; Float revenue; Direct payment from the plan Service code 12 | — | $25K |
| TRIA HEALTH, LLC EIN 27-1515235 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $20K |
| WEX HEALTH INC. FSA ADMINISTRATOR | Contract Administrator Service code 13 | 4321 20TH AVENUE SOUTH 605-697-1517 FARGO, ND 58103 | $8K |
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 | 343 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 545 | $88K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $36K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 259 | $370K |
| Other(5 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 545 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 545 | — |
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.