| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VXTRA PARTNERS Filed as: VXTRA PARTNERS, LLC | 2700 CUMBERLAND PKWY SUITE 140 ATLANTA, GA 30339 | BERKLEY LIFE & HEALTH INS CO | $0 | $0 | $0 | 0.00% |
| THE EASTMAN COMPANY INC3 | 201 MAIN STREET #1640 FORT WORTH, TX 76102 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $21K | — | $21K | 12.00% |
| DISABILITY INS ADVISORS LLC3 | 1600 AIRPORT FREEWAY SUITE 501 BEDFORD, TX 76022 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 5420 LBJ FREEWAY, SUITE 400 DALLAS, TX 75240 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | $185 | $10K | 10.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 5420 LBJ FREEWAY SUITE 400 DALLAS, TX 75240 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PL ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $116 | $116 | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 5420 LBJ FREEWAY, SUITE 400 DALLAS, TX 75240 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $105 | $3K | 15.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 5420 LBJ FREEWAY SUITE 400 DALLAS, TX 75240 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PL ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $24 | $24 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PL ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $12 | $12 | 0.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MANAGER | Float revenue; Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $590K |
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $166K |
| VXTRA PARTNERS, LLC EIN 02-0677823 BROKER | Other commissions Service code 55 | 2700 CUMBERLAND PARKWAY SUITE 140 ATLANTA, GA 30339 | $75K |
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 | 184 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 81 | $98K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 74 | $11K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $46K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 180 | $177K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INS CO | 184 | $520K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.
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.