| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 92643 LOS ANGELES, CA 90009 | KAISER FOUNDATION HEALTH PLAN INC | $144K | $8K | $151K | 3.24% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $4K | $9K | 2.55% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $3K | $18K | 11.95% |
| LOCKTON COMPANIES, LLC3 | THREE EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | $0 | $4K | 9.97% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | CALFORNIA DENTAL NETWORK | $1K | $0 | $1K | 10.00% |
No Schedule C service providers reported on this filing.
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 | 311 | 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) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 731 | $4.7M |
| Dental(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 479 | $379K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 497 | $36K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 225 | $152K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 225 | $152K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 731 | $4.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 731 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.