| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $2K | $16K | 8.07% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC - DALLAS | PO BOX 123042 DALLAS, TX 75312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $285 | $5K | 2.48% |
| NATIONAL BENEFITS PARTNERS LLC3 | 181 EAST 5600 SOUTH SUITE 240 SALT LAKE CITY, UT 84107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 181 EAST 5600 SOUTH SUITE 240 SALT LAKE CITY, UT 84107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.90% |
| NATIONAL BENEFITS PARTNER LLC3 Filed as: NATIONAL BENEFITS PARTNER | 181 EAST 5600 SOUTH SUITE 240 SALT LAKE CITY, UT 84107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.85% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN GRIFFIN | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $866 | — | $866 | 0.44% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 75312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $23K | — | $23K | 14.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 2.88% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 75312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $18K | — | $18K | 12.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 2.73% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 75312 | VISION SERVICE PLAN | $4K | — | $4K | 8.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WEBTPA EMPLOYER SERVICES INC EIN 75-2611444 ADMINISTRATOR | Claims processing Service code 12 | — | $549K |
| AETNA SIGNATURE ADMINISTRATORS EIN 06-6033492 NONE | Employee (plan) Service code 30 | — | $104K |
| AETNA BEHAVIORAL HEALTH EMPLOYEE AS EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $39K |
| DIVERSIFIED BENEFIT SERVICES INC EIN 39-1695622 ADMINISTRATOR | Claims processing Service code 12 | — | $15K |
| HEQ EIN 52-2383166 NONE | Claims processing Service code 12 | — | $14K |
| CONEXIS EIN 20-0198855 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $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 | 2,174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 817 | $45K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,421 | $361K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 315 | $0 |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,421 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,421 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.