| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $103K | $21K | $124K | 14.06% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | UNITED HEALTHCARE INSURANCE COMPANY | $64K | $0 | $64K | 9.05% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $17K | $4K | $21K | 12.40% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURG, PA | $2K | — | $2K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 450 COLUMBUS BLVD. HARTFORD, CT 06103 | $448K |
| DELTA DENTAL EIN 23-7322578 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 100 FIRST STREET SAN FRANCISCO, CA 94105 | $95K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 | Contract Administrator Service code 13 | 100 LIBERTY WAY DOVER, NH 03820 | $66K |
| UNITED HEALTHCARE SERVICES INC FLEX EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 450 COLUMBUS BLVD HARTFORD, CT 06103 | $35K |
| VISION SERVICE PLAN EIN 06-1227840 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 123042 DALLAS, TX 75312 | $25K |
| LOCKTON COMPANIES LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | 2100 ROSS AVENUE DALLAS, TX 75201 | $0 |
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 | 1,862 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,863 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,862 | $884K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,722 | $169K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 4,216 | $702K |
| Other(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,862 | $893K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,216 | — |
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.