| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | — | $26K | $26K | 5.00% |
| LOCKTON COMPANIES, LLC3 | THREE CITY PLACE DRIVE, SUITE 900 SAINT LOUIS, MO 63141 | HARTFORD LIFE AND ACCIDENT | $29K | — | $29K | 17.83% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | — | $7K | $7K | 4.35% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | EYEMED VISION CARE | $2K | — | $2K | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC. EIN 33-0441200 RX BENEFIT MANAGEMENT | Direct payment from the plan; Other fees; Claims processing; Float revenue Service code 12 | — | $653K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $94K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | — | $31K |
| DELTA DENTAL OF KANSAS, INC. EIN 48-0793267 ADMINISTRATOR | Contract Administrator Service code 13 | — | $12K |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 402 | $24K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 384 | $162K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 384 | $162K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 189 | $528K |
| Other | HARTFORD LIFE AND ACCIDENT | 384 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 402 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.