| 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 | AETNA LIFE INSURANCE COMPANY | $13K | — | $13K | 1.85% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| THOMAS CHRISTOPHER SMITH3 Filed as: THOMAS SMITH | PO BOX 6650 METAIRIE, LA 70009 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $455 | — | $455 | 0.70% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.52% |
| DOUGLAS JAMES3 | 2 BIRCH STREET UPPER SADDLE RIVER, NJ 07458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.15% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.71% |
| THOMAS CHRISTOPHER SMITH3 Filed as: THOMAS SMITH | PO BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $282 | — | $282 | 1.07% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 20.00% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | VISION SERVICE PLAN | $650 | — | $650 | 7.49% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 1166 AVENUE OF THE AMERICAS 34TH FLOOR NEW YORK, NY 10036 | ZURICH AMERICAN INSURANCE COMPANY | $237 | — | $237 | 24.95% |
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 | 451 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 453 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 439 | $733K |
| Dental | AETNA LIFE INSURANCE COMPANY | 439 | $713K |
| Vision | VISION SERVICE PLAN | 79 | $9K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 441 | $127K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 254 | $65K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $44K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 439 | $713K |
| Other(5 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 446 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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."
No prospect flags tripped on this filing.