| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 1.73% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $15K | $15K | 5.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $713K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $64K |
| 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 | 1,623 | 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) | 1,623 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,141 | $201K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 2,670 | $446K |
| Short-term disability(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,404 | $71K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,260 | $300K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,785 | $1.4M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 2,670 | $547K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,785 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.