| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST SUITE 900A DALLAS, TX 75217 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $30K | $30K | 1.02% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP SE | 40 WALL ST STE 1304 NEW YORK, NY 100051304 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | — | $14K | 12.12% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 753123042 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 8.44% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INS SERVICES LLC | 1250 S CAPITAL OF TEXAS HWY BLDG 2 STE 125 AUSTIN, TX 787466446 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Named fiduciary; Direct payment from the plan; Participant communication; Other services; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing Service code 12 | — | $60K |
| CIGNA | Contract Administrator; Other services; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
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 | 3,347 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 71 | $957K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 680 | $184K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 6,766 | $2.9M |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 680 | $298K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,766 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.