| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $220 | $0 | $220 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 16.05% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $35 | $35 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.54% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 6.16% |
| MELISSA A KOLL3 | 216 CLIMAX DRIVE DILLON, CO 80435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $680 | $166 | $846 | 4.47% |
| EVAN D BURDEN3 | PO BOX 6903 DENVER, CO 80206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $483 | $3 | $486 | 2.57% |
| VOLUNTARY SOLUTIONS INC3 | 9903 E 150TH AVENUE BRIGHTON, CO 80602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275 | $76 | $351 | 1.85% |
| DAWN RENEE MORGAN3 | 6413 DUNMOOR DRIVE PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $191 | $0 | $191 | 1.01% |
| FOREVER EMPLOYER LTD3 | 375 EAST HORSETOOTH ROAD FORT COLLINS, CO 80525 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.07% |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 229 | $856K |
| Vision | VISION SERVICE PLAN | 150 | $21K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 192 | $151K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 192 | $132K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 192 | $132K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 192 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.