| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | OXFORD HEALTH INSURANCE, INC. | $102K | $5K | $108K | 2.36% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | OXFORD HEALTH INSURANCE, INC. | $34K | — | $34K | 0.75% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF NEW YORK | $8K | — | $8K | 3.73% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLILP NEW YORK, NY 10005 | DELTA DENTAL OF NEW YORK | $3K | — | $3K | 1.27% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $2K | $11K | 10.09% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.90% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $101 | $101 | 0.09% |
| JACQUES P DAVID CORPORATION3 Filed as: JACQUES P. DAVID CORPORATION | 125 JERICHO TURNPIKE, SUITE 201 JERICHO, NY 11753 | AFLAC | $4K | $36 | $4K | 6.26% |
| ALBERT BRUCKNER3 | 3018 BROADWAY, SUITE 2E ASTORIA, NY 11106 | AFLAC | $2K | $50 | $2K | 3.39% |
| JEAN DAVID3 | 125 JERICHO TURNPIKE, SUITE 201 JERICHO, NY 11753 | AFLAC | $1K | $14 | $1K | 2.28% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORPORATION | 401 FRANKLIN AVENUE, SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $778 | $14 | $792 | 1.37% |
| MICHAEL S CHILLE3 Filed as: MICHAEL S. CHILLE | 22 CORPORATE WOODS BOULEVARD 4TH FLOOR ALBANY, NY 12211 | AFLAC | $260 | — | $260 | 0.45% |
| TIMOTHY L. PENNEY3 Filed as: TIMOTHY PENNEY | 204 HUDSON STREET, SUITE 5 HOBOKEN, NJ 07030 | AFLAC | $236 | — | $236 | 0.41% |
| MJ INSURANCE3 Filed as: DAVID HRKACH AND VARIOUS AGENTS | PO BOX 10202 LAHAINA, HI 96761 | AFLAC | $79 | — | $79 | 0.14% |
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 | 304 | 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) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OXFORD HEALTH INSURANCE, INC. | 350 | $4.6M |
| Dental | DELTA DENTAL OF NEW YORK | 361 | $225K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 304 | $112K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 304 | $112K |
| Prescription drug | OXFORD HEALTH INSURANCE, INC. | 350 | $4.6M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 304 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.