| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 0.40% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $323 | $323 | 0.41% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 25.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $1K | — | $1K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 25.00% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 ADMINISTRATOR | Contract Administrator Service code 13 | — | $161K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 ADMINISTRATOR | Contract Administrator Service code 13 | — | $28K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $11K |
| CVS PHARMACY, INC EIN 05-0340626 ADMINISTRATOR | Contract Administrator Service code 13 | — | $2K |
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 | 293 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 375 | $260K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 158 | $78K |
| Other(7 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 375 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.