| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VARIOUS - SEE ATTACHMENT3 Filed as: VARIOUS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37K | $11K | $48K | 15.07% |
| VARIOUS - SEE ATTACHMENT3 Filed as: VARIOUS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13K | $2K | $15K | 12.87% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $9K | $2K | $11K | 10.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $8K | $2K | $10K | 9.95% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $6K | $1K | $7K | 10.84% |
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 | 2,289 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CT, INC. | 2,288 | $308K |
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 3,213 | $48K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 3,459 | $537K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 3,147 | $382K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,497 | $113K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 3,459 | $421K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,497 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.