| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES LLC | 2100 ROSS AVE SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$203 | $12K | $12K | 1.81% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 1.11% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 15939 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | KAISER FOUNDATION HEALTH PLAN INC | $21K | — | $21K | 4.83% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES LLC | 2100 ROSS AVE SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$100 | $6K | $6K | 1.99% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | C/O BANK OF AMERICA 159339 COLLECTIONS CENTER DR CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.24% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES LLC | 2100 ROSS AVE SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$80 | $6K | $6K | 2.29% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | C/O BANK OF AMERICA 159339 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 1.13% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES INC | 15939 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 4.50% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | CHICAGO SERIES 15939 COLLECTIONS CTR DRIVE CHICAGO, IL 60693 | METROPOLITAN GENERAL INSURANCE COMPANY | $2K | $69 | $2K | 16.17% |
| JAMES A STEWART3 | 5825 MEDLOCK BRIDGE PARKWAY SUITE 200 ALPHARETTA, GA 30022 | METROPOLITAN GENERAL INSURANCE COMPANY | $1K | — | $1K | 7.41% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES-MTN WEST SERIES | DEPT 999228 P O BOX 173850 DENVER, CO 80217 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $191 | $191 | 1.25% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | DEPT 3042 P O BOX 123042 DALLAS, TX 75312 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | -$34 | $250 | $216 | 5.78% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON CMPANIES LLC | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | — | $3 | $3 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $249K |
| FRINGE BENEFIT GROUP EIN 74-2124394 ADMIN | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $20K |
| FIRST HEALTH EIN 20-1736437 PPO FEE | Insurance services Service code 23 | — | $5K |
| RELATION INSURANCE SERVICES EIN 26-0291031 BROKER | Insurance agents and brokers; Insurance services Service code 22 | — | $4K |
| LOCKTON COMPANIES LLC EIN 20-3354970 BROKER | Insurance agents and brokers; Insurance services Service code 22 | — | $3K |
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 | 1,512 | 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) | 1,512 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 68 | $670K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 2,481 | $2.4M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 642 | $678K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,115 | $256K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 596 | $281K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 2,481 | $2.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,512 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,481 | — |
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.