| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $23K | $4K | $27K | 2.24% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | DEARBORN LIFE INSURANCE COMPANY | $63K | $8K | $71K | 16.90% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET SUITE 3400 CHICAGO, IL 60661 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 1.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | INSURANCE SERVICES P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 0.87% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | BLUECROSS BLUESHIELD OF ILLINOIS | $3K | $150 | $4K | 1.94% |
| LOCKTON COMPANIES, LLC3 | 500 W. MONROE STREET SUITE 3400 CHICAGO, IL 60661 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 2.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | INSURANCE SERVICES P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 2.36% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 123042 DALLAS, TX 75312 | VISION SERVICE PLAN | $2K | — | $2K | 3.70% |
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 | 466 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 185 | $1.9M |
| Vision | VISION SERVICE PLAN | 319 | $47K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 202 | $421K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 202 | $421K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 202 | $421K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 185 | $1.9M |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 204 | $428K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.