| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE, STE 1200 DALLAS, TX 75201 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $63K | $63K | 3.80% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH ST. SUITE 900 KANSAS CITY, MO 641121906 | METROPOLITAN LIFE INSURANCE COMPANY | — | $23K | $23K | 1.48% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 752012739 | METROPOLITAN LIFE INSURANCE COMPANY | — | $43 | $43 | 0.00% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $19K | — | $19K | 14.62% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CIRCLE DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $11K | — | $11K | 17.25% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $6K | — | $6K | 15.71% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $3K | — | $3K | 12.41% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $4K | — | $4K | 26.99% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $2K | — | $2K | 15.65% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $1K | — | $1K | 14.66% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CIRCLE DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $1K | — | $1K | 20.49% |
| LAURENCE K. PROVENCE3 | 111 EXECUTIVE CENTER DRIVE SUITE 206 COLUMBIA, SC 29210 | AMERICAN HERITAGE LIFE INSURANCE | $269 | — | $269 | 14.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 CONTRACT ADMINISTRATOR | Insurance services; Contract Administrator; Claims processing Service code 12 | — | $1.5M |
| SUNLIFE INSURANCE COMPANY OF CANADA EIN 38-1082080 NONE | Claims processing Service code 12 | — | $27K |
| LOCKTON COMPANIES, LLC NONE | Consulting (general); Insurance agents and brokers; Other insurance fees and expenses; Insurance brokerage commissions and fees Service code 16 | 2100 ROSS AVE SUITE 1200 DALLAS, TX 75201 | $18K |
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 | 3,690 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 99 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,826 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts) | AMERICAN HERITAGE LIFE INSURANCE | 402 | $300K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 5,155 | $1.5M |
| Vision | EYE MED | 4,577 | $230K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,690 | $1.7M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,690 | $1.7M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,690 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,155 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.