| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | UNKNOWN DALLAS, TX 75201 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $22K | $40 | $22K | 6.99% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.91% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $70 | $70 | 0.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $65 | $65 | 0.04% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 8.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.16% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $561 | $0 | $561 | 0.80% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $76 | $76 | 0.11% |
| LOCKTON COMPANIES, LLC3 | UNKNOWN, DEPARTMENT LA 23940 PASADENA, CA 91185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $2K | $9K | 19.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62899 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $650 | $0 | $650 | 1.38% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | FEDERAL INSURANCE COMPANY | $655 | $136 | $791 | 24.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | — | $89K |
| EXPRESS SCRIPTS EIN 43-1420563 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | — | $81K |
| GSA NATIONAL EIN 11-3335620 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $73K |
| CITRIN COOPERMAN EIN 22-2428965 PLAN AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $54K |
| THE PRUDENTAL INSURANCE COMPANY EIN 22-1211670 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | — | $6K |
| HR SIMPLIFIED EIN 41-1877873 BEN ADMIN | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $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 | 386 | 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) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 442 | $159K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 285 | $311K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $70K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $70K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 285 | $311K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 386 | $432K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 442 | — |
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.