| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 1.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $0 | $14K | 7.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | 10TH FLOOR 18100 VON KARMAN AVENUE IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $580 | $580 | 0.34% |
| GBS BENEFITS INC3 | 2200 S MAIN STREET, SUITE 600 SALT LAKE CITY, UT 84115 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $166 | $0 | $166 | 0.10% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $0 | $126 | 0.07% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS INSURANCE AGENCY | 525 EAST 100 SOUTH SUITE 200 SALT LAKE CITY, UT 84102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $0 | $19K | 19.15% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $994 | $0 | $994 | 1.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 10TH FLOOR 18100 VON KARMAN AVENUE IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $553 | $553 | 0.56% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $879 | $0 | $879 | 1.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.53% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $120 | $120 | 0.32% |
| GBS BENEFITS INC3 | 2200 SOUTH MAIN STREET, SUITE 600 SALT LAKE CITY, UT 84115 | FIRST UNUM LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.02% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 11.45% |
| ALLIANT INSURANCE SERVICES, INC.3 | 10TH FLOOR 18100 VON KARMAN AVENUE IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $97 | $97 | 0.37% |
| GBS BENEFITS INC3 | SUITE 600 2200 SOUTH MAIN STREET SALT LAKE CITY, UT 84115 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21 | $0 | $21 | 0.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7 | $0 | $7 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.61% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | $0 | $10 | 4.15% |
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 | 1,786 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,805 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENT HEALTH BENEFITS CORPORATION | 219 | $592K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 2,229 | $673K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 2,229 | $673K |
| Life insurance(6 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,786 | $752K |
| Short-term disability(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 303 | $217K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,786 | $252K |
| Prescription drug | INDEPENDENT HEALTH BENEFITS CORPORATION | 78 | $381K |
| Other(7 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,786 | $781K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,229 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.