| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN, INC. | $213K | $0 | $213K | 1.37% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $91K | — | $91K | 1.38% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $5K | $5K | 0.08% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | SIMNSA | $29K | $0 | $29K | 6.91% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET 52ND FLOOR LOS ANGELES, CA 90017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $0 | $21K | 5.31% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES, LLC | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $18K | $18K | 4.53% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES, LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 0.47% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $21K | $0 | $21K | 10.33% |
| EMPOWER BENEFITS INC3 Filed as: EMPOWER BENEFITS, INC. | 3606 ENTERPRISE AVENUE SUITE 304 NAPLES, FL 34104 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9K | $0 | $9K | 11.17% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS INS. | 3155 OLSEN DRIVE, SUITE 400 SAN JOSE, CA 95117 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | $0 | $8K | 9.30% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS INS. | 3155 OLSEN DRIVE SUITE 400 SAN JOSE, CA 95117 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.52% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | BLUE CROSS AND BLUE SHIELD OF LOUISIANA | $3K | $0 | $3K | 5.21% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP, INC. | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $574 | — | $574 | 4.55% |
| DINO J. CICCONE4 | 16889 CARMICHAEL AVENUE CALDWELL, ID 83607 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $473 | $0 | $473 | 3.75% |
| EMPOWER BENEFITS GROUP4 | 17W635 BUTTERFIELD ROAD SUITE 300 OAKBROOK TERRACE, IL 60181 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $262 | $0 | $262 | 2.08% |
| SIMON PONCE4 | 1100 LILY CACHE LANE APARTMENT 204 BOLINGBROOK, IL 60490 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $30 | — | $30 | 0.24% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $169 | $17 | $186 | 21.99% |
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 | 2,083 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,091 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,538 | $22.6M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,538 | $7.0M |
| Vision | VISION SERVICE PLAN | 1,487 | $200K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,083 | $474K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,083 | $393K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,538 | $22.6M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,083 | $487K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,083 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.