| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON GA - SOUTHEAST | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | — | $42K | $42K | 5.00% |
| BENEFIT HELP3 | PO BOX 38366 GERMANTOWN, TN 381830366 | HUMANADENTAL INSURANCE COMPANY | $57K | — | $57K | 9.83% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 25.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF TENNESSEE EIN 62-0427913 NONE | Contract Administrator Service code 13 | — | $2.3M |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $174K |
| KEVIN MCDANIEL NONE | Contract Administrator Service code 13 | 3 CITY PLACE DR STE 900 SAINT LOUIS, MO 63141 | $17K |
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 | 3,650 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 873 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,523 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HUMANADENTAL INSURANCE COMPANY | 3,162 | $584K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,332 | $1.6M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,350 | $683 |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,780 | $1.1M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 9,290 | $901K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,333 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,290 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.