| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $90 | $90 | 0.31% |
| LOCKTON COMPANIES, LLC4 Filed as: LOCKTON BENEFIT COMPANY | 444 W 47TH STREET STE 600 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD OF KANSAS CITY | $12K | — | $12K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROUSE, FRETS,WHITE,GOSS,GENTILE, RH EIN 43-1706479 FUND LEGAL COUNSEL | Legal; Direct payment from the plan Service code 29 | — | $154K |
| INNOVATIVE SOFTWARE SOLUTIONS INC SOFTWARE PROVIDER | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 3000 S LENOLA RD MAPLE SHADE, NJ 08052 | $89K |
| MICHELLE ROSS EIN 44-6013920 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| LOCKTON COMPANIES LLC EIN 48-0763803 CONSULTANT | Direct payment from the plan; Other commissions; Consulting (general) Service code 16 | — | $72K |
| FINANCIAL COUNSELORS EIN 43-0890172 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | — | $50K |
| MALLORY BURNETTE EIN 44-6013920 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $31K |
| SSC CPA'S P.A. EIN 48-1215584 FUND AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| STACIE BAKER EIN 44-6013920 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $19K |
| MIDWEST TRUST CUSTODIAL & BANKING | Account maintenance fees; Direct payment from the plan; Investment management; Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | 5901 COLLEGE BLVD OVERLAND PARK, KS 66211 | $11K |
| TAYLOR COBBINS EIN 44-6013920 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $9K |
| HORIZON ACTUARIAL EIN 26-1370698 PLAN ACTUARY | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
| KIRA DEATLEY EIN 44-6013920 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $7K |
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 | 487 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 66 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 553 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 522 | $0 |
| Dental | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 522 | $0 |
| Vision | VISION PLAN SERVICES | 570 | $0 |
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 523 | $39K |
| Prescription drug | ELIXIR CRAFTED RX SOLUTIONS | 555 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 1,353 | $0 |
| Other(3 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 458 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,353 | — |
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.