| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 15.47% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417483 BOSTON, MA 02241 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 14.76% |
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK 3RD FLOOR FARMINGTON, CT 06032 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | $0 | $6K | 23.03% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $80 | $0 | $80 | 0.93% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $270 | $0 | $270 | 8.37% |
| LOCKTON COMPANIES, LLC4 Filed as: LOCKTON INSURANCE BROKERS LLC | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $152 | $0 | $152 | 4.71% |
| MARY THERESA FISHER4 | 898 UNION CHURCH RD TOWNSEND, DE 197349113 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $41 | — | $41 | 1.27% |
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK 3RD FLOOR FARMINGTON, CT 06032 | CHLIC ON BEHALF OF METLIFE | $607 | — | $607 | 26.36% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BSA INC DBA GSA NATIONAL EIN 11-3335620 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $51K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 26 | $36K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 26 | $36K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 150 | $17K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 282 | $50K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 282 | $48K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 282 | $50K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $8K |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 282 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.