| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $83K | — | $83K | 4.77% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | -$22K | — | -$22K | -1.24% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | PAN-AMERICAN LIFE INSURANCE COMPANY | $5K | — | $5K | 4.84% |
| LOCKTON COMPANIES, LLC3 | 3280 PEACHTREE ROAD NE NW SUITE 800 ATLANTA, GA 30305 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $17 | $4K | 6.03% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $964 | $964 | 1.44% |
| MIA (JUAN M. CRUZ ORTA)3 | PO BOX 70333 SAN JUAN, PR 00936 | MAPFRE LIFE INSURANCE COMPANY | $630 | — | $630 | 1.68% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | VISION SERVICE PLAN | $4K | — | $4K | 10.00% |
| LOCKTON COMPANIES, LLC3 | 3280 PEACHTREE ROAD NE SUITE 800 ATLANTA, GA 30305 | SUN LIFE ASSURANCE COMPANY OF CANADA | $549 | — | $549 | 14.99% |
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 | 372 | 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) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 289 | $2.0M |
| Dental(4 contracts, 4 carriers) | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 289 | $2.0M |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 250 | $134K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 282 | $71K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 282 | $71K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 282 | $4K |
| Prescription drug(4 contracts, 4 carriers) | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 289 | $2.0M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 282 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.