| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 0.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $578 | $0 | $578 | 0.64% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.82% |
| BUSINESS INSURANCE AGENCY DBA CROSS3 Filed as: BUSINESS INS AGENCY INC | PO BOX 469 AUGUSTA, ME 04332 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $701 | — | $701 | 0.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: THE DUNLAP CORPORATION - WILLIS HRH | PO BOX 469 AUGUSTA, ME 04332 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $463 | — | $463 | 0.56% |
| MASTER UNUM ENROLL3 | 1 FOUNTAIN SQ CHATTANOOGA, TN 37402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $333 | — | $333 | 0.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 2 MONUMENT SQ PORTLAND, ME 04104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $160 | — | $160 | 0.19% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $490 | $0 | $490 | 0.66% |
| LEBEL & HARRIMAN3 | 366 US ROUTE ONE FALMOUTH, ME 04105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $913 | $0 | $913 | 3.82% |
| LEBEL & HARRIMAN3 | 366 US ROUTE ONE FALMOUTH, ME 04105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $65 | $0 | $65 | 3.29% |
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 | 1,377 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,392 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,377 | $703K |
| Short-term disability(3 contracts) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 243 | $108K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 565 | $90K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,377 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,377 | — |
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.