| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | $40K | — | $40K | 5.38% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY N STE 500 DEERFIELD, IL 60015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 4.51% |
| IMG5 | 3960 N MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $192 | $192 | 0.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 11166 AVENUE OF THE AMERICAS 23RD FLOOR NEW YORK, NY 10036 | HARTFORD LIFE AND ACCIDENT | $503 | — | $503 | 25.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 1166 AVENUE OF THE AMERICA NEW YORK, NY 10036 | HARTFORD LIFE INSURANCE COMPANY | $34 | — | $34 | 24.82% |
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 | 1,077 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 213 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 205 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,704 | $830K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,704 | $830K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,077 | $346K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,077 | $346K |
| Prescription drug | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 205 | $750K |
| Other(7 contracts, 5 carriers) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 1,077 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,704 | — |
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.