| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON DUNNING COMPANIES LLC | 2100 ROSS AVENUE SUITE 200 DALLAS, TX 75201 | UNIMERICA INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 NONE | Direct payment from the plan; Non-monetary compensation; Contract Administrator; Other services; Float revenue; Named fiduciary; Claims processing; Participant communication Service code 12 | — | $101K |
| TABEN EIN 48-1197135 NONE | Contract Administrator Service code 13 | — | $25K |
| PICKETT, CHANEY & MCMULLEN, LLP EIN 48-1246310 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| BANK OF AMERICA, N.A. EIN 94-1687665 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $11K |
| DELTA DENTAL OF KANSAS, INC. EIN 48-0793267 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $6K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 232 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.