| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $44K | — | $44K | 3.10% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIASTAR LIFE INSURANCE COMPANY | $16K | — | $16K | 3.85% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 0.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Participant communication; Direct payment from the plan; Non-monetary compensation; Claims processing; Contract Administrator; Other services; Float revenue; Named fiduciary Service code 12 | — | $850K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $73K |
| WEX ADMINISTRATOR | Contract Administrator Service code 13 | 4321 20TH AVENUE S 701-969-6706 FARGO, ND 58103 | $19K |
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 | 1,342 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,137 | $195K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 2,632 | $423K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,338 | $61K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,360 | $213K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,745 | $1.4M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 2,632 | $516K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,745 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.