| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSP GROUP BENEFITS INC3 | 206 S JEFFERSON STREET CHICAGO, IL 60661 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $2K | $4K | 5.06% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 4.55% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 17.87% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 23.10% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 18.53% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $876 | — | $876 | 5.43% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $904 | $2K | 18.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF KANSAS CITY EIN 43-1257251 ADMINISTRATOR | Contract Administrator Service code 13 | — | $79K |
| LOCKTON COMPANIES, LLC BROKER | Insurance agents and brokers Service code 22 | 444 WEST 47TH STREET,900 KANSAS CITY, MO 64112 | $18K |
| DISCOVERY BENEFITS ADMINISTRATOR | Contract Administrator Service code 13 | 4321 20TH AVE S FARGO, ND 58103 | $5K |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 324 | $86K |
| Vision | VISION SERVICE PLAN | 97 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $18K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $40K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.