| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOBENEFITS LLC3 | 1280 BRIGHTON WAY NEW TOWN SQUARE, PA 19073 | TRANSAMERICA LIFE INSURANCE COMPANY | $22K | — | $22K | 3.85% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE, SUITE 3400 CHICAGO, IL 60661 | HM LIFE INSURANCE COMPANY | $29K | — | $29K | 10.00% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $15K | $20K | 7.80% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $16K | — | $16K | 10.00% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $4K | $7K | 10.66% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $3K | $12K | 22.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 701 MARKET STREET SAINT LOUIS, MO 63101 | NATIONAL UNION FIRE INS. CO. OF PITTSBURG, PA | $6K | — | $6K | 20.00% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $802 | $263 | $1K | 21.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 61-1237516 HEALTH ADMINISTRATOR | Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue Service code 12 | — | $2.6M |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 RX ADMINISTRATOR | Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $404K |
| HEALTH ADVOCATE, INC. EIN 23-3080019 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $159K |
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $84K |
| HUMANADENTAL INSURANCE COMPANY EIN 39-0714280 DENTAL ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $79K |
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $50K |
| MULTIPLAN EIN 35-2048379 ADMINISTRATOR | Contract Administrator Service code 13 | — | $27K |
| RGI, LLC EIN 32-0176370 ADMINISTRATOR | Contract Administrator Service code 13 | — | $22K |
| TASC FSA ADMINISTRATOR | Contract Administrator Service code 13 | 221 W COLLEGE AVENUE 920-749-3547 APPLETON, WI 54912 | $19K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $11K |
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 | 2,166 | 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) | 2,166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HM LIFE INSURANCE COMPANY | 5,092 | $295K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,177 | $317K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,166 | $161K |
| Other(6 contracts, 4 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 2,500 | $763K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,092 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.