| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $29K | $74K | $103K | 7.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $290 | $11K | 14.07% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $221 | $8K | 14.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 MEDICAL ADMINISTRATOR | Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $1.6M |
| LOCKTON COMPANIES, LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | — | $230K |
| PRUDENTIAL EIN 23-1503749 STD/FMLA ADMINISTRATOR | Contract Administrator Service code 13 | — | $89K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $49K |
| MHN SERVICES, LLC EIN 95-4146179 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $31K |
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 | 1,528 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,540 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 23 | $177K |
| Vision | EYEMED VISION CARE | 2,637 | $222K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,903 | $760K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,903 | $760K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3,075 | $1.5M |
| Other(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,903 | $891K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,075 | — |
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."
No prospect flags tripped on this filing.