| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $0 | $10K | 0.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US, LLC | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 0.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US, LLC | PO BOX 28852 NEW YORK, NY 10087 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $11K | $11K | 1.28% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 0.56% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $377 | $377 | 0.04% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | $0 | $6K | $6K | 1.26% |
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 | 1,411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 102 | $1.0M |
| Dental | DENTEGRA INSURANCE COMPANY | 209 | $36K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 2,710 | $187K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,943 | $864K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,721 | $441K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 102 | $1.0M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,943 | $909K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,710 | — |
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.