| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P.O. BOX 123103 DALLAS, TX 75312 | ANTHEM INSURANCE COMPANIES, INC. | $25K | — | $25K | 4.15% |
| INDY CHAMBER LLC3 | 111 MONUMENT CIR STE 1950 INDIANAPOLIS, ID 46204 | ANTHEM INSURANCE COMPANIES, INC. | $944 | — | $944 | 0.16% |
| THOMAS SCHAFFLER3 | 525 W MONROE STE 600 CHICAGO, IL 60661 | PRIORITY HEALTH | $14K | — | $14K | 3.23% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 525 WEST MONROE SUITE 600 CHICAGO, IL 60661 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 10.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 550 W MONROE ST STE 3400 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 13.60% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 ATTN TELLYE HEDRICK KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $788 | $788 | 2.10% |
No Schedule C service providers reported on this filing.
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM INSURANCE COMPANIES, INC. | 146 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $105K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $105K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 130 | $37K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 130 | $37K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 130 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.