| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 0.09% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| DAVID J MCCLELLAN3 Filed as: DAVID MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $482 | $7K | 17.05% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.75% |
| THOMAS CHRISTOPHER SMITH3 Filed as: THOMAS SMITH | PO BOX 40386 798 BERRY ROAD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $187 | — | $187 | 0.48% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COMPANION LIFE INSURANCE | $2K | — | $2K | 8.35% |
| MITCH BESVINICK3 | 1280 BRIGHTON WAY NEW TOWN SQUARE, PA 19073 | COMPANION LIFE INSURANCE | $971 | — | $971 | 3.43% |
| DAVID J MCCLELLAN3 Filed as: DAVID MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $134 | $2K | 12.23% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $771 | — | $771 | 5.09% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 20.00% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | VISION SERVICE PLAN | $878 | — | $878 | 6.47% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | MUTUAL OF OMAHA INSURANCE COMPANY | $432 | — | $432 | 9.99% |
| DAVID J MCCLELLAN3 Filed as: DAVID MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | FIRST UNUM LIFE INSURANCE COMPANY | $89 | $9 | $98 | 39.04% |
| DOUGLAS JAMES3 | 2 BIRCH COURT UPPER SADDLE RIVER, NJ 07458 | FIRST UNUM LIFE INSURANCE COMPANY | $38 | — | $38 | 15.14% |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 131 | $2.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 131 | $2.8M |
| Vision | VISION SERVICE PLAN | 98 | $14K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 302 | $119K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 149 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 302 | $39K |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 302 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.