| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | HARTFORD LIFE AND ACCIDENT | $0 | $154K | $154K | 4.16% |
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION, SUITE 700 DENVER, CO 80237 | BLUE CROSS OF CALIFORNIA | $0 | $5K | $5K | 0.14% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | LIFE INSURANCE OF NORTH AMERICA | $0 | $15K | $15K | 0.77% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $29K | $0 | $29K | 3.47% |
| CGF INSURANCE LLC3 | UNKNOWN HOUSTON, TX 77219 | TRIPLE S SALUD, INC | $33K | $0 | $33K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | AETNA LIFE INSURANCE COMPANY | $0 | $132 | $132 | 0.05% |
| STEVEN PAULI INSURANCE3 Filed as: STEVEN A. PAULI INSURANCE | PO BOX 363909 SAN JUAN, PR 00936 | DELTA DENTAL OF PUERTO RICO | $2K | $0 | $2K | 5.00% |
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 | 19,590 | 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) | 19,590 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,655 | $15.3M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,432 | $325K |
| Vision | VISION SERVICE PLAN | 8,805 | $1.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 19,590 | $3.7M |
| Long-term disability | LIFE INSURANCE OF NORTH AMERICA | 19,590 | $2.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 19,590 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,590 | — |
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."
No prospect flags tripped on this filing.