| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $11K | $11K | 5.05% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $7K | $7K | 5.19% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $236 | $67 | $303 | 2.57% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | NATIONAL UNION FIRE INS. CO. | $1K | — | $1K | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF NEBRASKA EIN 47-0095156 MEDICAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $461K |
| DELTA DENTAL OF NEBRASKA EIN 47-0685003 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $23K |
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 STD ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $21K |
| FAMILY HEALTH AMERICA, LC (EMPOWER) EIN 48-1185152 FSA ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| CURALINC, LLC EIN 33-1206383 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $13K |
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 | 770 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 785 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 3 | $66K |
| Dental | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 3 | $66K |
| Vision | VISION SERVICE PLAN | 836 | $89K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 770 | $283K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 770 | $191K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 685 | $503K |
| Other(5 contracts, 5 carriers) | ARMADACARE | 989 | $707K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 989 | — |
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.