| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SVCS LLC | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $76K | — | $76K | 4.13% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SRVCS LLC | PO BOX 830324 PHILADELPHIA, PA 19182 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $66K | — | $66K | 3.61% |
| THE PLEXUS GROUPE LLC3 Filed as: PLEXUS GROUPE LLC | 21805 FIELD PKWY STE 300 DEEP PARK, IL 60010 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $52K | — | $52K | 2.85% |
| IMG5 | 2960 N MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $320 | $320 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | GPO BOX 27447 CORPORATE LOCKBOX NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $86K | — | $86K | 26.65% |
| MERCER HEALTH AND BENEFITS, LLC3 | 15 WEST SOUTH TEMPLE STE 700 SALT LAKE CITY, UT 84101 | LLOYDS OF LONDON | $24K | — | $24K | 25.73% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | CORPORATE LOCK BOX GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 25.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN, LLC | CORPORATE LOCK BOX GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15K | — | $15K | 42.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INS CO OF AMERICA EIN 22-1211670 NONE | Insurance services; Insurance agents and brokers Service code 22 | — | $96K |
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 | 1,832 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 57 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,908 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 38 | $36K |
| Vision | VISION SERVICE PLAN | 1,264 | $244K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,832 | $1.8M |
| Short-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,832 | $2.2M |
| Long-term disability(4 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,832 | $2.3M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,832 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,832 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.