| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | METROPOLITAN LIFE INSURANCE COMPANY | $33K | $60 | $34K | 2.90% |
| BSC AGENCY LLC3 | 1025 ASHWORTH ROAD SUITE 101 WEST DES MOINES, IA 50265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $32K | $32K | 2.75% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $5K | $24K | 2.10% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $13K | $13K | 1.10% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | EYEMED VISION CARE O/B/O THE COMBINED INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 3.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE O/B/O THE COMBINED INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 0.98% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | EYEMED VISION CARE O/B/O THE COMBINED INSURANCE COMPANY OF AMERICA | $172 | — | $172 | 19.91% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE O/B/O THE COMBINED INSURANCE COMPANY OF AMERICA | $55 | — | $55 | 6.37% |
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 | 16,882 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 128 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,010 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 756 | $4.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,708 | $1.2M |
| Vision(2 contracts) | EYEMED VISION CARE O/B/O THE COMBINED INSURANCE COMPANY OF AMERICA | 17,838 | $695K |
| Life insurance | AETNA LIFE INSURANCE CO. | 18,048 | $2.7M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 8,162 | $1.2M |
| Other | ARCH INSURANCE COMPANY | 7,771 | $385K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 18,048 | — |
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.