| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | $73K | $0 | $73K | 3.43% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | PAN AMERICAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | AETNA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AETNA LIFE INSURANCE COMPANY | $0 | $273 | $273 | 0.30% |
| LOCKTON COMPANIES, LLC3 | 3280 PEACHTREE ROAD NE NW SUITE 800 ATLANTA, GA 30305 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $52 | $4K | 4.91% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $971 | $971 | 1.20% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | VISION SERVICE PLAN | $3K | $0 | $3K | 9.95% |
| MIA (JUAN M. CRUZ ORTA)3 Filed as: MIA JUAN M. CRUZ ORTA | PO BOX 70333 SAN JUAN, PR 00936 | MAPFRE LIFE INSURANCE COMPANY OF PUERTO RICO | $512 | $0 | $512 | 2.00% |
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 | 543 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 555 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 329 | $2.4M |
| Dental(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 329 | $2.4M |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 263 | $142K |
| Life insurance(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 274 | $199K |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 274 | $173K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 274 | $92K |
| Prescription drug(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 329 | $2.4M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 274 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 329 | — |
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.