| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC AHP | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740045 | UNITEDHEALTHCARE INSURANCE COMPANY | $26K | — | $26K | 2.53% |
| SAVAGE & ASSOCIATES INC3 Filed as: SAVAGE & ASSOCIATES INC. | 655 BEAVER CREEK CIRCLE MAUMEE, OH 435371738 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 0.65% |
| MCCAMON HUNT INSURANCE AGENCY INC3 Filed as: MCCAMON-HUNT INS. AGENCY INC. | PO BOX 818078 CLEVELAND, OH 441818078 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 0.15% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVCS OF N. CAROLINA | 11215 N COMMUNITY HOUSE ROAD SUITE 100 CHARLOTTE, NC 282774961 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 0.13% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES OH INC. | 6450 ROCKSIDE WOODS BLVD. S SUITE 250 INDEPENDENCE, OH 441312237 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 0.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 75 ARLINGTON STREET FLOOR 10 BOSTON, MA 021163936 | UNITEDHEALTHCARE INSURANCE COMPANY | $874 | — | $874 | 0.08% |
| DAVID E. GREENWAY3 Filed as: DAVID E GREENWAY | 631 LAKE AVENUE PUEBLO, CO 810042387 | UNITEDHEALTHCARE INSURANCE COMPANY | $749 | — | $749 | 0.07% |
| CHAPPELL SMITH & ASSOCIATES INC3 Filed as: CHAPPELL SMITH & ASSOCIATES INC. | PO BOX 681209 FRANKLIN, TN 370681209 | UNITEDHEALTHCARE INSURANCE COMPANY | $722 | — | $722 | 0.07% |
| CAROL C. BALLENGER3 | 3607 SPERRY AVENUE NASHVILLE, TN 372151035 | UNITEDHEALTHCARE INSURANCE COMPANY | $551 | — | $551 | 0.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONG STAR INS SVCS. | 6707 GESSNER DRIVE HOUSTON, TX 770404017 | UNITEDHEALTHCARE INSURANCE COMPANY | $479 | — | $479 | 0.05% |
| FLOOD & PETERSON BENEFITS LLC3 Filed as: FLOOR & PETERSON INSURANCE INC. | 4687 187TH ST. GREELEY, CO 806343216 | UNITEDHEALTHCARE INSURANCE COMPANY | $469 | — | $469 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740045 | UNITEDHEALTHCARE INSURANCE COMPANY | $414 | — | $414 | 0.04% |
| DOCHTERMAN INSURANCE SERVICES, INC.3 | 4 PARK PLAZA SUITE 1750 IRVINE, CA 926148601 | UNITEDHEALTHCARE INSURANCE COMPANY | $378 | — | $378 | 0.04% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 493 | $1.0M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 493 | $1.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 493 | $1.0M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 493 | $1.0M |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 493 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 493 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.