| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $140K | — | $140K | 11.13% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $41K | — | $41K | 3.23% |
| IMG5 | 2960 NORTH NERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $299 | $299 | 0.02% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METLIFE LEGAL PLANS | $5K | $162 | $5K | 10.26% |
| LOCKTON COMPANIES, LLC3 | PO BOX 173850 DENVER, CO 80217 | METLIFE LEGAL PLANS | — | $338 | $338 | 0.65% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ZURICH AMERICAN INSURANCE COMPANY | $917 | — | $917 | 19.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 ADMINISTRATOR | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $2.0M |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 DENTAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $164K |
| THE PRUDENTIAL INSURANCE CO. OF AM. EIN 22-1211670 FMLA ADMINISTRATOR | Contract Administrator Service code 13 | — | $50K |
| COMPSYCH EIN 35-3739783 TPA | Contract Administrator Service code 13 | — | $37K |
| LOCKTON COMPANIES, LLC BROKER | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 444 WEST 47TH ST., 900 KANSAS CITY, MO 64112 | $27K |
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 | 1,529 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 475 | $5.3M |
| Vision | VISION SERVICE PLAN | 1,283 | $290K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,214 | $1.3M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,214 | $1.3M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,214 | $1.3M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 475 | $5.3M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,214 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,214 | — |
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.