| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARVARD PILGRIM HEALTHCARE | $25K | — | $25K | 2.47% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVE STE 201 CLIFTON, NJ 07013 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 8.32% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVE STE 201 CLIFTON, NJ 07013 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 18.92% |
| GROUP ADVISORY INC3 Filed as: GROUP ADVISORY, INC. | 1135 CLIFTON AVENUE CLIFTON, NJ 07013 | FEDERAL INSURANCE COMPANY | $3K | — | $3K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $88K |
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 | 453 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO | 279 | $38K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 362 | $221K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 362 | $150K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 421 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 421 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.