| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $23K | $23K | 5.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | STANDARD INSURANCE COMPANY | $67K | $18K | $85K | 19.88% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | STANDARD INSURANCE COMPANY | $30K | $7K | $37K | 21.86% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | STANDARD INSURANCE COMPANY | $22K | $4K | $26K | 31.71% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 752016527 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $1K | $7K | 12.70% |
| REED HEADLEY SCHNITTKER3 | 2400 DALLAS PKWY STE 260 PLANO, TX 75093 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 9.18% |
| BRUCE A. SAMMIS3 Filed as: BRUCE A SAMMIS | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 7.34% |
| WESTON BRYAN3 | 3741 SHADY HILL DR DALLAS, TX 75229 | STANDARD INSURANCE COMPANY | $848 | — | $848 | 2.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 ADMINISTRATOR | Named fiduciary; Participant communication; Contract Administrator; Claims processing; Float revenue; Non-monetary compensation; Other services; Direct payment from the plan Service code 12 | — | $666K |
| EVERNORTH BEHAVIORNAL HEALTH, INC. EIN 41-1648670 ADMINISTRATOR | Direct payment from the plan; Claims processing; Participant communication; Contract Administrator Service code 12 | — | $9K |
| COSMOL, INC. DBA TAXSAVER PLAN EIN 75-1761182 ADMINISTRATOR | Claims processing Service code 12 | — | $4K |
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 | 416 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 903 | $55K |
| Life insurance | STANDARD INSURANCE COMPANY | 459 | $428K |
| Short-term disability | STANDARD INSURANCE COMPANY | 17 | $38K |
| Long-term disability | STANDARD INSURANCE COMPANY | 459 | $169K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 980 | $467K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 980 | — |
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.