| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 N MICHIGAN AVE 15TH FLOOR CHICAGO, IL 60611 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $102K | $2K | $104K | 2.48% |
| PAUL FLOTKEN3 | — | HARVARD PILGRIM HEALTH CARE | $30K | — | $30K | 0.88% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST #900 KANSAS CITY, MO 64112 | HARVARD PILGRIM HEALTH CARE | $18K | — | $18K | 0.53% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $48K | $68K | 6.99% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | C/O BANK OF AMERICA PO BOX 505115 ST. LOUIS, MO 63150 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $7K | $7K | 0.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | NORTH SCOTTSDALE RD #410 SCOTTSDALE, AZ 85254 | AETNA LIFE INSURANCE CO | $11K | — | $11K | 1.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5482 WILISHIRE BLVD., STE 1566 LOS ANGELES, CA 90036 | AETNA LIFE INSURANCE CO | $5K | — | $5K | 0.87% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $13K | $18K | 6.49% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | C/O BANK OF AMERICA PO BOX 505115 ST. LOUIS, MO 63150 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 0.76% |
| PAUL FLOTKEN3 | — | HARVARD PILGRIM HEALTH CARE | $3K | — | $3K | 1.18% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST #900 KANSAS CITY, MO 64112 | HARVARD PILGRIM HEALTH CARE | $2K | — | $2K | 0.89% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | NORTH SCOTTSDALE RD #410 SCOTTSDALE, AZ 85254 | AETNA INTERNATIONAL | $1K | — | $1K | 0.82% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD STE 1150 LOS ANGELES, CA 90025 | CIGNA LIFE INSURANCE CO OF NEW YORK | $344 | $1K | $2K | 6.16% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 505115 ST LOUIS, MO 63150 | CIGNA LIFE INSURANCE CO OF NEW YORK | $0 | $110 | $110 | 0.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Float revenue; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | — | $57.0M |
| LOCKTON COMPANIES LLC EIN 20-3395470 ACTUARY | Actuarial; Consulting (general) Service code 11 | — | $114K |
| BANK OF NEW YORK MELLON EIN 13-5160382 INVESTMENT SERVICES | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $46K |
| CONDUENT CONSULTING ACTUARY | Consulting (general); Actuarial Service code 11 | 100 CAMPUS DRIVE SUITE 200 FLORHAM PARK, NJ 07932 | $42K |
| BUCK CONSULTANTS, LLC EIN 13-3954297 ACTUARY | Actuarial; Consulting (general) Service code 11 | — | $24K |
| HALEY & ASSOCIATES, LLC EIN 55-0810153 AUDIT | Accounting (including auditing) Service code 10 | — | $14K |
| BROWN SMITH WALLACE LLP EIN 43-1001367 TAX PREP | Accounting (including auditing) Service code 10 | — | $7K |
| ACRISURE OF CALIFORNIA, LLC EIN 38-3942950 NONE | Consulting (general) Service code 16 | — | $0 |
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 | 8,970 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 51 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,021 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(10 contracts, 6 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 11,055 | $37.4M |
| Dental(5 contracts, 3 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 11,055 | $25.3M |
| Vision | EYEMED VISION CARE | 11,614 | $532K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 15,692 | $671K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 10,493 | $969K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 11,055 | $7.0M |
| Other(7 contracts, 7 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 44,922 | $7.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 44,922 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.