| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $22K | $22K | 0.34% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | — | $1K | 5.95% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $279 | $279 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 BEHAVIORAL CARE PROVIDER | Float revenue; Other services; Claims processing; Direct payment from the plan; Participant communication; Contract Administrator Service code 12 | — | $2.3M |
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 ADMINISTRATION | Contract Administrator Service code 13 | — | $139K |
| CBIZ BENEFITS & INSURANCE SERVICES EIN 31-1582098 BROKER | Insurance agents and brokers Service code 22 | — | $0 |
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 | 33,953 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 34,020 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 69,587 | $4.8M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 69,587 | $4.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 69,587 | $11.7M |
| Life insurance(2 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 35,389 | $9.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $0 |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 31,434 | $6.5M |
| Other(3 contracts, 3 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 69,587 | $12.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 69,587 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.