| 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 | — | $161K | $161K | 7.68% |
| THE PLEXUS GROUPE LLC3 Filed as: PLEXUS GROUPE LLC | 21805 FIELD PKWY STE 300 DEEP PARK, IL 60010 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $42K | $42K | 1.98% |
| IMG5 | 2960 N MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $407 | $407 | 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 | — | $31K | $31K | 13.84% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN, LLC | CORPORATE LOCKBOX GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $39K | $39K | 69.38% |
| 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 | — | $6K | $6K | 22.65% |
| 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 | — | $5K | $5K | 19.89% |
| MERCER HEALTH AND BENEFITS, LLC3 | 15 WEST SOUTH TEMPLE STE 700 SALT LAKE CITY, UT 84101 | LLOYDS OF LONDON | $2K | — | $2K | 24.93% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN, LLC | CORPORATE LOCKBOX GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $4K | $4K | 75.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INS CO OF AMERICA EIN 22-1211670 NONE | Insurance agents and brokers; Insurance services Service code 22 | — | $113K |
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 | 1,998 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,021 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 20 | $25K |
| Vision | VISION SERVICE PLAN | 1,344 | $254K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,998 | $2.1M |
| Short-term disability(5 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,998 | $2.4M |
| Long-term disability(5 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,998 | $2.4M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,998 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,998 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.