| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.00% |
| BXS INSURANCE INC3 Filed as: BANCORPSOUTH INS SERVICES INC. | 4041 ESSEN LN SUITE 400 BATON ROUGE, LA 70808 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 3453.33% |
| GROUP RISK SPECIALISTS INC3 Filed as: GROUP RISK SPECIALISTS INC. | 3340 PEACHTREE RD NE SUITE 1690 ATLANTA, GA 303261012 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $16 | $2K | 932.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $197K |
| BUSINESS LEGACY MANAGEMENT, LLC EIN 83-0445255 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $170K |
| MERCER HUMAN RESOURCES CONSULT. LLC EIN 13-2834414 BENEFIT CONSULT ACTUARY | Consulting (general); Actuarial Service code 11 | — | $92K |
| SANDRA'S CREATIONS EIN 72-1615670 BENEFITS ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $52K |
| LTD CONSULTING, LLC EIN 11-3373840 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $36K |
| AGINCOURT CAPITAL MANAGEMENT, LLC EIN 54-1947440 INVESTMENT MANAGER | Investment management Service code 28 | — | $24K |
| HUNTER-MICHAEL INVST. ADVISORS, INC EIN 54-1870462 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | — | $18K |
| STEPHEN C. HIMEL, CPA, LLC EIN 20-8410792 AUDITOR | Accounting (including auditing) Service code 10 | — | $17K |
| CAPITAL ONE, NA EIN 72-0210640 CUSTODIAN | Custodial (securities); Account maintenance fees; Distribution (12b-1) fees Service code 19 | — | $6K |
| BANK OF MONTREAL EIN 36-2085229 CUSTODIAN | Sub-transfer agency fees; Shareholder servicing fees Service code 59 | — | $0 |
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 | 348 | 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) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 288 | $234K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 348 | $106K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 291 | $225 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.