| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA, 52ND FLOOR LOS ANGELES, CA 90017 | AETNA LIFE INSURANCE CO. | $72K | $4K | $76K | 3.20% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN INC | — | $26 | $26 | 0.03% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $584 | $584 | 1.19% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $305 | $305 | 1.30% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $471 | $3K | 24.52% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $522 | — | $522 | 5.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $317 | $2K | 24.07% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $389 | — | $389 | 5.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $285 | — | $285 | 5.01% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METLIFE LEGAL PLANS | $322 | $63 | $385 | 9.49% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 92617 | ZURICH AMERICAN INSURANCE COMPANY | $484 | — | $484 | 14.99% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $77 | — | $77 | 6.63% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23 | — | $23 | 1.98% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY ROAD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | — | $10 | 0.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WEX ADMINISTRATOR | Contract Administrator Service code 13 | 700 26TH AVENUE E WEST FARGO, ND 58078 | $6K |
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 | 233 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 385 | $2.4M |
| Dental | AETNA LIFE INSURANCE CO. | 385 | $2.4M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 328 | $28K |
| Life insurance(3 contracts) | SECURIAN LIFE INSURANCE COMPANY | 233 | $84K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 233 | $49K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 74 | $24K |
| Other(5 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 620 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 620 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.