| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | BLUECROSS BLUESHIELD OF KANSAS CITY | $60K | $31K | $91K | 6.21% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 0.59% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 2.00% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | — | $4K | 3.01% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $683 | $683 | 2.10% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $124 | $124 | 0.47% |
| VERNE LAVINIER KIDD4 | 529 CELTIC ASH RUN CIBOLO, TX 78108 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $670 | — | $670 | 4.03% |
| BRIAN PARKER4 | 1110 COGBURN COURT SHADY SHORES, TX 76208 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $303 | — | $303 | 1.82% |
| BARBARA MIGL4 | 1404 ADAMS ROAD BULVERDE, TX 78163 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $281 | — | $281 | 1.69% |
| LOVELACE KIDD JR4 Filed as: LOVELACE KIDD JR. | 147 ELAINE ROAD SAN ANTONIO, TX 78222 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $162 | — | $162 | 0.97% |
| REBECCA I. YBARRA LEAN4 | 15402 N. HOEHN ROAD EDINBURG, TX 78541 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $150 | — | $150 | 0.90% |
| ANGEL R. QUINTERO3 | 4630 N. PALM VIEW CIR N. CHARLESTON, SC 29418 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $149 | — | $149 | 0.90% |
| KEVIN W. TAYLOR | 3318 IVANHOE LANE ABILENE, TX 79605 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $106 | — | $106 | 0.64% |
| KIMBERLY FERRIS4 | 48 BERNHARDT DRIVE AMHERST, NY 14226 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $73 | — | $73 | 0.44% |
| HAROLD GONZALES4 | 3029 HUDSON CIR. NW ALBUQUERQUE, NM 87107 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $58 | — | $58 | 0.35% |
| THOMAS OWENS4 Filed as: THOMAS W. OWENS | P.O. BOX 781431 WICHITA, KS 67278 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $38 | — | $38 | 0.23% |
| ROSALIA SEPULVEDA4 | 8943 LINELL LANE CORDOVA, TN 38016 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $31 | — | $31 | 0.19% |
| KEVIN PUTNAM4 | 12408 RIVER BEND AUSTIN, TX 78732 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $29 | — | $29 | 0.17% |
| IZELA DOW4 | P.O. BOX 842 CULEBRA, TX 00775 | PREPAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $23 | — | $23 | 0.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $597K |
| CIGNA EIN 23-1503749 STD ADMINISTRATOR | Contract Administrator Service code 13 | — | $54K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $41K |
| CERIDIAN CORPORATION EIN 41-1981625 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $36K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | — | $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 | 982 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 990 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF KANSAS CITY | 367 | $1.6M |
| Vision | EYEMED VISION CARE | 1,596 | $126K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,835 | $278K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 119 | $33K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 962 | $168K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 1,851 | $726K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,210 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,851 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.